Regular Member Drugs110 Posted August 11, 2020 Regular Member Share Posted August 11, 2020 Should I hop on dut? Link to comment Share on other sites More sharing options...
Senior Member Future Hair Doc Posted August 11, 2020 Senior Member Share Posted August 11, 2020 Usually you need to take finasteride 1mg daily for 1 year to assess fully if it's working or not. Having said that, I think starting dutasteride should be fine. It's a LOT more potent than finasteride so I usually start my patients off on 0.5mg daily. I would also use topical minoxidil. Good luck My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. Link to comment Share on other sites More sharing options...
Regular Member Drugs110 Posted August 11, 2020 Author Regular Member Share Posted August 11, 2020 29 minutes ago, Dr. Suhail Khokhar said: Usually you need to take finasteride 1mg daily for 1 year to assess fully if it's working or not. Having said that, I think starting dutasteride should be fine. It's a LOT more potent than finasteride so I usually start my patients off on 0.5mg daily. I would also use topical minoxidil. Good luck So should I drop the fin and use dut only? Link to comment Share on other sites More sharing options...
Senior Member Future Hair Doc Posted August 11, 2020 Senior Member Share Posted August 11, 2020 (edited) I think switching meds will be fine. Obviously talk to your doctor about switching over. You should also be using minoxidil. Edited August 11, 2020 by Dr. Suhail Khokhar My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. Link to comment Share on other sites More sharing options...
Regular Member Drugs110 Posted August 11, 2020 Author Regular Member Share Posted August 11, 2020 2 minutes ago, Dr. Suhail Khokhar said: I think switching meds will be fine. Obviously talk to your doctor about switching over. You should also be using minoxidil. Topical min doesn't work for me. I had tried it for 6 months when I stopped. Link to comment Share on other sites More sharing options...
Senior Member Future Hair Doc Posted August 12, 2020 Senior Member Share Posted August 12, 2020 It's not going to regrow hair...it's used to try to maintain existing hair. Remember, 5-alpha reductase inhibitors like finasteride and vasodilators like minoxidil are used mainly to keep hair from falling out, not growing it. My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. Link to comment Share on other sites More sharing options...
Regular Member Drugs110 Posted August 12, 2020 Author Regular Member Share Posted August 12, 2020 6 minutes ago, Dr. Suhail Khokhar said: It's not going to regrow hair...it's used to try to maintain existing hair. Remember, 5-alpha reductase inhibitors like finasteride and vasodilators like minoxidil are used mainly to keep hair from falling out, not growing it. Not true from what I've read and been told by docs. Minoxidil does regrow hair, it's a hair growth stimulant, not a DHT blocker. Link to comment Share on other sites More sharing options...
Senior Member Future Hair Doc Posted August 12, 2020 Senior Member Share Posted August 12, 2020 25 minutes ago, Drugs110 said: Not true from what I've read and been told by docs. Minoxidil does regrow hair, it's a hair growth stimulant, not a DHT blocker. Yes, minoxidil is a vasodilator, not a DHT blocker. My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. Link to comment Share on other sites More sharing options...
Senior Member PizzaWolf Posted August 12, 2020 Senior Member Share Posted August 12, 2020 3 hours ago, Dr. Suhail Khokhar said: Usually you need to take finasteride 1mg daily for 1 year to assess fully if it's working or not. Having said that, I think starting dutasteride should be fine. It's a LOT more potent than finasteride so I usually start my patients off on 0.5mg daily. I would also use topical minoxidil. Good luck You start patients off at 0.5mg daily of Dutasteride? What dose do you work up to? Link to comment Share on other sites More sharing options...
Senior Member Future Hair Doc Posted August 14, 2020 Senior Member Share Posted August 14, 2020 I just start at 0.5mg and don't go higher. It's a lot more potent than finasteride with a similar side effect profile. I haven't seen studies using a dose higher than 0.5mg and am leery to go higher than that. Also, given the fact it's more potent the chances of side effects are higher. My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. Link to comment Share on other sites More sharing options...
Regular Member Drugs110 Posted August 14, 2020 Author Regular Member Share Posted August 14, 2020 1 hour ago, Dr. Suhail Khokhar said: I just start at 0.5mg and don't go higher. It's a lot more potent than finasteride with a similar side effect profile. I haven't seen studies using a dose higher than 0.5mg and am leery to go higher than that. Also, given the fact it's more potent the chances of side effects are higher. Do you use oral minoxidil? Link to comment Share on other sites More sharing options...
Senior Member Future Hair Doc Posted August 14, 2020 Senior Member Share Posted August 14, 2020 15 hours ago, Drugs110 said: Do you use oral minoxidil? I personally don't. Low dose (2.5mg to 5mg) oral minoxidil has been used successfully to treat androgenic alopecia with a low side effect profile: https://www.jaad.org/article/S0190-9622(19)30685-1/pdf 1 My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. Link to comment Share on other sites More sharing options...
Regular Member Drugs110 Posted August 14, 2020 Author Regular Member Share Posted August 14, 2020 12 minutes ago, Dr. Suhail Khokhar said: I personally don't. Low dose (2.5mg to 5mg) oral minoxidil has been used successfully to treat androgenic alopecia with a low side effect profile: https://www.jaad.org/article/S0190-9622(19)30685-1/pdf How common is edema and dangerous heart arrythmia at those doses? Link to comment Share on other sites More sharing options...
Senior Member Future Hair Doc Posted August 14, 2020 Senior Member Share Posted August 14, 2020 9 minutes ago, Drugs110 said: How common is edema and dangerous heart arrythmia at those doses? Not common at all. I'd start off at 2.5mg obviously (lowest dose) and the most I'd go up is 5mg. Obviously talk to your doctor since everyone reacts differently and you might have other comorbidities that would put you at a higher risk for side effects. 2 My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. Link to comment Share on other sites More sharing options...
Senior Member ciaus Posted August 14, 2020 Senior Member Share Posted August 14, 2020 (edited) Hello Dr. Khokhar, I really appreciate your contributions here, great to have a medical professional weigh in on topics. I'm thinking about starting up 1.25mg/day dosage, already saw my doctor and have a script for 2.5mg pills, cut in half per day. There's a doctor clinic up in Canada that has some blog topics on oral minoxidil in the links below, and the dosage ranges for results start lower, even below that 1.25mg. It sounds like from your last reply that you start prescriptions at 2.5mg. Is that based on your patient results not responding to lower doses? or fellow doctor results/literature etc? This is on my radar because I have a scarring alopecia (LPP) that has thankfully been in remission and was pretty mild even when it was active -and some scalp sebhorrheic dermatitis. So I stay away from topical medicines since I can't predict skin irritation flareups. The idea of stopping the minoxidil to deal with sheds while I get things back under control is a non-starter for me. https://donovanmedical.com/hair-blog/oral-minoxidil-topical-allergy https://donovanmedical.com/hair-blog/topical-to-oral-minoxidil https://donovanmedical.com/hair-blog Edited August 14, 2020 by ciaus Link to comment Share on other sites More sharing options...
Senior Member Future Hair Doc Posted August 15, 2020 Senior Member Share Posted August 15, 2020 On 8/14/2020 at 2:17 PM, ciaus said: Hello Dr. Khokhar, I really appreciate your contributions here, great to have a medical professional weigh in on topics. I'm thinking about starting up 1.25mg/day dosage, already saw my doctor and have a script for 2.5mg pills, cut in half per day. There's a doctor clinic up in Canada that has some blog topics on oral minoxidil in the links below, and the dosage ranges for results start lower, even below that 1.25mg. It sounds like from your last reply that you start prescriptions at 2.5mg. Is that based on your patient results not responding to lower doses? or fellow doctor results/literature etc? This is on my radar because I have a scarring alopecia (LPP) that has thankfully been in remission and was pretty mild even when it was active -and some scalp sebhorrheic dermatitis. So I stay away from topical medicines since I can't predict skin irritation flareups. The idea of stopping the minoxidil to deal with sheds while I get things back under control is a non-starter for me. https://donovanmedical.com/hair-blog/oral-minoxidil-topical-allergy https://donovanmedical.com/hair-blog/topical-to-oral-minoxidil https://donovanmedical.com/hair-blog Great question. I start off at 2.5mg based on published literature, as well as results from other physicians and my own practice. Use the following to guide your research: https://www.practiceupdate.com/content/effectiveness-and-safety-of-low-dose-oral-minoxidil-in-male-androgenetic-alopecia/83335 https://www.jaad.org/article/S0190-9622(19)30685-1/pdf 1 My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. Link to comment Share on other sites More sharing options...
Senior Member ciaus Posted August 15, 2020 Senior Member Share Posted August 15, 2020 17 minutes ago, Dr. Suhail Khokhar said: Great question. I start off at 2.5mg based on published literature, as well as results from other physicians and my own practice. Thanks Dr. Khokhar, I started the 1.25mg and I have a follow up with my doctor in November. Assuming I have no side effects in the meantime I'm going to print those pages out and talk with him about the 2.5 dosage. Link to comment Share on other sites More sharing options...
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