How Effective are Propecia (Finasteride) and Dutasteride (Avodart) in Treating Hair Loss?

I went to my doctor today and got a finasteride prescription. Now I’m reading that dutasteride may be more effective. Does anyone have any comparative experiences? Have you seen any people actually regrow hair by getting on finasteride (or dutasteride)?

avodart-propeciaMost guys are using Propecia (finasteride) for hair loss. Avodart (dutasteride) is typically reserved for the day when finasteride is no longer sustaining hair growth and hair loss once again begins to advance.

There are probably a number of reasons for this. First, dutasteride is not FDA approved as a hair loss treatment so many physicians won’t prescribe it. Second, dutasteride tends to be more expensive and, lastly, as it inhibits both the type 1 and type 2 alpha-reductase enzyme (the enzyme associated with the conversion of testosterone to DHT), side effects can be more severe.

In terms of the effectiveness of Propecia in the treatment of androgenic alopecia, there are three potential outcomes. The first potential outcome is that it regrows hair. This is pretty easy to assess and document photographically.

The second potential outcome is that is slows the progression of male pattern baldness, allowing you to retain more of your existing hair over a longer period of time. This outcome is not so easy to measure. If you take the drug for five or ten years and still have most of your hair, how could you know for certain that you wouldn’t have had the same outcome without the drug?

Experiencing Side Effects on Propecia (finasteride) for Hair Loss, but not Avodart (dutasteride)?

This question comes from a member of our Hair Loss Social Community and Discussion Forums: 

Several months ago, I began taking Propecia (finasteride) for my progressive hair loss and experienced significant side effects. After stopping the medication, I switched to Avodart (dutasteride), another medication sometimes indicated in hair restoration, and did not experience any adverse side effects. Is there a reason for this? Should I continue taking the Avodart?

Finasteride (the active ingredient in Propecia) works by blocking the DHT (dihydrotestosterone – the hormone responsible for genetic baldness) converting activity of the type II 5-alpha-reductase enzyme. Dutasteride (the active ingredient in Avodart) works by inhibiting the activity of both the type I and type II 5-alpha-reductase enzymes. Although Propecia is shown to be just as effective, I’m not certain that utilizing one medication over the other would produce different side effects, as they are very, very similar drugs.

Regardless, there could be a variety of reasons why the Avodart is working without negative side effects, and if this will help prevent the progression of your hair loss, I think you should confirm and safety and efficacy of the pill with your hair restoration physician and keep utilizing it as a preventive measure. Additionally, keep in mind that Propecia is the only oral medication officially approved for treating progressive hair loss and usually causes side effects in a very small patient population (according to the official studies, less than 3%).

FDA Warns Hair Loss Drugs Propecia (Finasteride) and Avodart (Dutasteride) May Increase Risk of Prostate Cancer?

Can the hair loss treatments Propecia (finasteride) and Avodart (dutasteride) increase risks of cancer?

Last week, the U.S. Food and Drug Administration (FDA) released a statement claiming the drugs Avodart and Proscar, typically used to treat benign prostate hyperplasia (prostate enlargement) in men, may increase the risks of high-grade prostate cancer.

The news came suddenly after two large clinical trials revealed the increased risks (ironically enough, both drugs were tested as a method of preventing prostate cancer in late 2010), and now individuals at the FDA are pushing the makers of Avodart and Proscar to include prostate cancer warning labels on prescription bottles.

While this news is important for individuals taking these medications for prostate enlargement issues, the announcement also comes as a surprise to hair loss patients, as the active ingredient in both Avodart and Proscar is dutasteride and finasteride (respectively).  These two compounds are used to block the action of 5-alpha-reductase enzymes – proteins responsible for converting testosterone to the hair loss inducing, dihydrotestosterone (DHT) form.

Finasteride is also the key ingredient in the hair loss drug Propecia, which is proven safe and effective for treating male pattern baldness, and although the amount of finasteride in Propecia is greatly reduced (compared to Proscar), the FDA believes it should now carry a similar warning label (although it was not one of the drugs included in the initial clinical trial).

Dutasteride (Avodart) Versus Finasteride (Propecia) for Male Pattern Hair Loss?

This question comes from a member of our Hair Loss Social Community and Discussion Forums:

I’ve started researching preventive hair loss medications and find myself confused about the difference between dutasteride (Avodart) and finasteride (Propecia) for male pattern baldness. What is the difference between these two medications?

In theory, the biggest difference between dutasteride and finasteride is that dutasteride blocks both forms (type 1 and type 2) of the alpha-reductase enzyme that is associated with the conversion of testosterone to dihydrotestosterone – the hormone responsible for hair loss, whereas finasteride only blocks type 2.

However, it was my understanding that only the type 2 enzyme is actually associated with the significant testosterone to dihydrotestosterone conversion as far as hair loss is concerned, and only blocking type 2 effectively prevents male baldness (though some studies argue that dutasteride/Avodart demonstrated a higher hair count while utilizing the medication).

Additionally, most people likely utilize finasteride (specifically in Propecia) above dutasteride because it has been tested and proven safe and effective for treating male hair loss. Furthermore, some hair loss sufferers report issues with the additional costs of dutasteride/Avodart and less available information regarding potential side effects.
Blake Bloxham – formerly “Future_HT_Doc”

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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Is Treating Hair Loss with Avodart (Dutasteride) Effective?

For over a decade, balding men have had two clinically proven options for treating their hair loss medically. !n 1988, Rogaine (minoxidil) 2% Topical Solution for Men launched as a prescription medication. Men’s Rogaine 5% Extra Strength Solution was approved for over-the-counter use in 1997. That same year, the FDA also approved finasteride to treat male pattern baldness (MPB) under the brand name Propecia. When used in combination, minoxidil and finasteride are still considered by many experts to be the best drug treatment for hair loss currently available.

However, over the past few years, some patients have begun to explore Avodart (dutasteride) as an alternative to finasteride. The reasons for this switch are varied. Some men hope that dutasteride will offer fewer side effects while others have simply not had success with Propecia and are looking for something more effective. Whatever the reason, it is important to note that Avodart is currently not FDA approved for the treatment of male pattern balding. So how does Avodart work? What are its side effects? How do you know if it’s time to make the switch?

Dutasteride, the active ingredient in Avodart is a 5-alpha-reductase inhibitor that inhibits the conversion of testosterone into dihydrotestosterone (DHT). As most balding men can tell you, DHT is the hormone responsible for androgenic alopecia or male pattern baldness. While Propecia (finasteride) only inhibits the Type II isoform of 5-alpha reductase, Avodart (dutasteride) blocks both Type I and Type II, potentially making it a more effective treatment for hair loss.

Avodart (Dutasteride) or Propecia (Finasteride) as a Hair Loss Drug?

I am considering using Avodart (dutasteride) as a hair loss treatment because it is supposedly stronger than Propecia (finasteride).   Does this sound like a good plan to regrow hair?

It appears that many more hair loss sufferers are turning to Avodart (dutasteride) for hair loss before first trying Propecia (finasteride).

Though Avodart (dutasteride) is said to potentially be a more potent hair loss drug,  it is not FDA approved for  hair loss.   Avodart (dutasteride) inhibits both type I and type II 5-alpha-reductase enzymes minimizing the production of DHT more than Propecia.   But with a more potentially potent drug comes more potentially potent side effects.

In my opinion, it would be better to try Propecia first, which has been FDA approved as a  hair loss medication. Many balding patients have great success with Propecia especially when combined with Rogaine 5%. (minoxidil).   Many hair restoration physicians will recommend trying Avodart as an alternate hair loss treatment in the event that Propecia isn’t working after 1 year of use.

Be sure however, to discuss these hair restoration treatments with a physician beforehand to learn fully about the benefits, limitations, and potential side effects.

Bill Seemiller
Associate Publisher of the Hair Transplant Network and the Hair Loss Learning Center
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Avodart Side Effects: What should I do?

I have been taking Avodart .5mg for about 6 weeks and  am experiencing  some pain in my testicles.   Do you know why this is?   What should I do?

Avodart is a medication that is prescribed by medical doctors for those who suffer from a large prostate.   Avodart works by decreasing the amount of Dihydrotestosterone (DHT) in the body which results in a smaller prostate. 0.5 mg of this medication is typically the recommended amount for this process to work.

As you may or may not be aware, Avodart (dutasteride) is not an FDA approved medication for hair loss.   Though it has been speculated  to be a stronger and more efficient  medication than Propecia (finasteride), it has not been fully tested.     Avodart, like Propecia is a DHT (the hormone responsible for the loss of genetically predisposed hairs)  inhibitor.

Reported potential side effects   of the medication according to the official Avodart website include: sexual side effects (such as impotence, decreased sex drive, decreased amount of semen, and impotence) and  swelling of the breasts.   Other less reported side effects include allergic reactions such as itching, swelling of the face or lips, hives, and rash.   According to their website, most side effects will stop after continued use of the medication.

If you are experiencing any of the above side effects or any side effects you think are related to Avodart, the best move would be to consult with  the doctor who prescribed it to you and explain your symptoms.

Avodart (Dutasteride) Dosing Charts

Avodart Chart

For anyone considering using Avodart (Dutasteride) to combat their male-pattern baldness, these charts should come in handy. The first one shows the amount of DHT inhibited by Avodart in concentrations of .1mg per day, .5 mg per day, and 2.5 mg per day. .5 mg per day is the dose prescribed to BPH (benign prostatic hyperplasia) sufferers and is often the dose taken by hair loss sufferers. View larger chart.

The next chart shows the amount of DHT inhibited by Avodart on different dosing schedules. The lines are kind of hard to see so I’ll list them here:

  • Purple line: 1.5 mg per day (3 Avodart pills) for 10 days and then .5 mg per day thereafter
  • Blue line: .5 mg per day
  • Green line: .5 mg per day for 2 days, then take one day off, then repeat
  • Red line: .5 mg every other day
  • Black line: Finasteride (Propecia/Proscar 1 mg per day) equivalent.

Avodart Chart 2

View larger chart.

As you can see, loading with 1.5 mg per day and then taking .5 mg per day thereafter inhibits the largest amount of DHT the fastest. You can achieve the same rate of inhibition with taking .5 mg per day from the start but it will take time to build in your system to its maximum levels of inhibition.When I started Avodart (and discontinued Propecia) I went ahead and took the loading method. I have been lucky enough to not have any side effects with Avodart thus far other than a brief shedding period that lasted about a month-and-a-half starting at around the two month mark. I have been using Avodart for about a year-and-a-half now with great results.

Propecia vs. Avodart: Which Internal DHT Inhibitor Should You Choose? Part 2

AvodartThis is Part 2 in a two part series. Before reading on you will want to read Part 1.

Avodart – an even stronger DHT inhibiting drug

Since the FDA approval of Propecia another DHT-inhibiting drug with great potential for inhibiting hair loss has come on the scene. This drug is called Dutasteride.
Dutasteride was developed by Glaxo-Smith Kline (GSK) and is marketed under the brand name Avodart. Like Finasteride, Dutasteride is a 5AR-inhibitor. However, unlike Finasteride, Dutasteride inhibits both Type I AR and Type II AR. Dutasteride also has a much longer half-life than Finasteride (Propecia) so any side effects that occur from use of the medication will be sustained for a much longer period of time.

Also like Propecia or Proscar, Avodart is available for prescription for treatment of BPH and has FDA approval for that application. However, testing of Dutasteride for the treatment of male-pattern baldness was discontinued by GSK for unknown reasons, though it is not thought to have been a safety issue since the drug is still available for BPH. This means that Avodart has not yet been FDA approved for the treatment of male pattern baldness.

Since Avodart is a dual 5AR inhibitor and is much stronger than Propecia, it is generally accepted that it is possible that it can be a more effective treatment for male pattern baldness. However, without sufficient testing this is speculative.

Propecia vs. Avodart: Which Internal DHT Inhibitor Should You Choose? Part 1

PropeciaHereditary hair loss will affect about half of the American male population. Luckily, in the past few years there have been drug hair loss treatments developed that can slow down, completely stop, or even reverse hair loss in some men. While there is still no hair loss cure, pills such as Propecia or Avodart have given many men hope for holding on to the hair they have and maybe even regaining some of what they lost. When considering a medicinal regimen, many hair loss sufferers find themselves asking which medication is right for them.

DHT’s role in producing hair loss

First, it is important to review what causes male pattern baldness. The culprit to male-pattern baldness is in the genes. Male-pattern baldness is hereditary. Myth indicates that the mothers’ side is to blame for a son’s thinning locks. But studies have shown that the genetic trait for hair loss is passed down through the genes from either parent.

Here is how hair loss actually works: The body produces an enzyme known as 5 alpha-reductase. The androgen hormone in the scalp produces testosterone. The testosterone mixes with the 5alpha-reductase producing Dihydrotestosterone or DHT for short. DHT is a more potent derivative of testosterone and is believed to cause male pattern baldness and when it binds to the receptor sites in hair follicles, which are genetically vulnerable to this process. Over time the DHT binding with these vulnerable receptors in the follicle slowly choke the follicles’ ability to produces healthy hairs.

Propecia the current FDA approved treatments for inhibiting DHT