My hemoglobulin is great, but no bleed for me: A Drug that Annoyed Me to No End When Being Developed Rules Me Out.

[NNadir]

I indicated I was going to donate blood today in another post: I hope to bleed like hell on Saturday.

I indicated that I'd failed the hemoglobulin test several times in recent years, so this time I took Slow Fe iron supplements every day all week. My hemoglobulin was great: 14.7, way over the cutoff at 12.

They have this enormous list of drugs they want to know if you're taking. I'm taking one: Finasteride, the development of which I was peripherally involved. I take it because of urinary urgency, prostate related, since most old men have enlarged prostrates. My urologist says my prostrate is fine, but possibly it's because, um, I'm taking the drug.

That was the original task for which the drug target for the drug, prostate issues.

But the reason it was being pushed hard - and it was - was the discovery for which it was repurposed, a "cure" for male pattern baldness, a cosmetic purpose.

At the time - this was 30 years ago - there were no major discovery developments in the pharmaceutical industry for malaria, at least none of which I was aware. The reason to my mind: Poor people in the global south get malaria; rich people in the global north do not. (With an overheating climate, this will no longer remain true.)

And that's the purpose for which finasteride was originally approved: Male pattern baldness. Prostate applications came later.

I was not in a position to say a damned thing about it, but internally and privately it pissed me off. Poor people died because there was no money in malaria, but old bald men chasing young women: They mattered.

The punch line is that finasteride has a side effect that is kind of fun given the application for which it was commercialized: Impotence, which led me to think of the internalized joke that fat, old, rich bald guys could now get the girl, but they couldn't do anything with her.

I'm taking it now as an old man for the original purpose in the discovery target, prostate enlargement, but I'm still fat and bald, so there's that, and, irrespective of the private joke I kept to myself, everything works as required when required, but the wild things do not matter as much as when my wife and I were younger.

I have no idea why you can't donate blood if you take it. Since it's a daily dose - I last took it until a few minutes ago, yesterday morning - it suggests it has a pretty fast pk (pharmacokinetics). I just looked it up. It has a Cmax (the maximum concentration after a dose) of 9.2 nanograms per milliliter, meaning a liter of blood has about a millionth of a gram of the drug. (The dose is 1 mg.)

Maybe I'll look into the issue, but I can't imagine for an approved drug, this is a big deal. Are they worried that a bleeding accident victim will grow hair?

I certainly hope that the blood supply is never so short as to lead to a loss of life because of rules that may be overly restrictuve, but it's their rules, not mine.

Urinary urgency is not a pleasant thing. I'm going to keep taking the drug; I'm not going to wash out for a month (what the tech suggested) needing to pee every 20 minutes or so. I guess my donor days are over.

It was a good run, and I hope that over the decades of donating, some life was saved somewhere by using my blood, just as my own life was saved by a donor over 50 years ago. Nevertheless, I'm done.

Sigh...