Finasteride vs Dutasteride - Is it worth switching after 4 years

[DavidJ]

Been on Finasteride for the last 4 or so years, with no side effects.

Wondering if it is worth switching to Dutasteride  as I have noticed my hair is thinning more over the last 9 months. 

[Hairwolf]

Just anecdotally, I  did something similar, was on it a few years and didn’t see that many (or so I thought) results so switched from fin to dut years ago and didn’t see much difference. Anecdotally is the key word here, as your experience might be totally different, so I guess you could give it a try if you are not getting satisfactory results from fin.

[Rahal Hair Transplant]

@DavidJ,

Hair loss is a progressive condition and though finasteride was working well for you for 4 years, as you said, you’ve noticed that your hair is starting to thin more recently.

It does make sense logically to consider switching from finasteride to dutasteride but before you do so, I do suggest that you speak to your physician about this.

Keep in mind while the medication dutasteride is more potent than finasteride, it also comes with a greater potential of side effects. This is because dutasteride blocks both type I and type 5 alpha reductase enzymes while finasteride only blocks type two.   As a result, less dihydrotestosterone aka DHT can be produced which means, reduced hair loss.

So while dutasteride wasn’t technically tested nor FDA approved for the treatment of hair loss, logically and in practice for many hair loss suffering men, dutasteride is certainly more affective in treating male pattern baldness.  On the other hand, The possibility of side effects is certainly greater. So again, I do suggest speaking to a physician prior to switching medication.

Best wishes,

Rahal Hair Transplant
 

[A_4_Archan]

@DavidJ

It is well known that duasteride is a much more powerful drug than finasteride and can slow down your hairloss. However, the side effects are also considerable, which makes me believe that this should not be done by you alone, but rather by a doctor who has a greater understanding of hairs, who will prepare all the necessary reports and then create a medication regime that safely suits your needs.

 

 

 

[DavidJ]

@A_4_Archan Thank you for the reply - what you have said makes sense. I will consult with a Doctor and see what they recommend. 

[DavidJ]

@Rahal Hair Transplant Thank for you the sound advise! 

[Al - Moderator]

Rather than immediately switching, you can try gradually switching by alternating between the two for a while. If that seems to be OK, then you can try dropping fin totally.

[HatMaster]

I can't disagree with the advice that you consult a doctor before beginning a prescription medication. That's always a prudent idea.

However, I don't think the claims that dutasteride has a more significant side effect profile are based in evidence. Studies that look at both typically show similar side effect rates for each drug. From my reading (note: not a doctor!), the primary downsides of dutasteride are:

1) It's less widely studied, so although we don't have a clinical reason to believe that the side effects are worse, we have less certainty about them, particularly regarding long term use.

2) It's only available in a gel capsule, so it's more difficult to titrate dosage.

3) The half life is much longer, so if you do encounter side effects, they will persist for longer after you stop taking the drug.

Meta-analysis comparing finasteride and dutasteride: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388756/

Nice youtube summarizing the body of clinical evidence: 

 

[ThePerseverantWarrior]

After 18 months of unsatisfactory results on finasteride, I switched to a fin 5x a week + dutasteride 2x a week combo a couple of months ago. And I am only 25 years old! 

If you haven't experienced side effects from finasteride and have age on your side (i.e., you're 30+), you should certainly consider switching or adding dutasteride to your finasteride regimen. Needless to say, since dutasteride requires a prescription, you'll need to keep your doctor in loop.