Dutasteride (Avodart): What You Need To Know
Written by Ann-Marie D’Arcy-Sharpe / Medically reviewed by Dr. Ashley Steffens
Highlights
- Only approved for men
- Prescription-only
- Risk of sexual dysfunction
One pill a day
$18-102 /month
What Is Dutasteride
What Is Dutasteride?
Dutasteride is a treatment for androgenetic alopecia, which is also known as pattern hair loss. It was originally used to treat enlarged prostates; specifically, a condition called benign prostatic hypertrophy (BPH). It was approved in the US to treat BPH in 2001. (1) In recent years, it has shown promise as a treatment for hair loss.
Dutasteride is not yet approved by the FDA as a hair loss treatment. It was approved as a treatment for androgenetic alopecia in 2009 in Korea and Japan. Dutasteride for both hair loss and BPH is typically taken orally as a 0.5 milligram dose. (2)
Dutasteride is also sold under the brand names Avodart or Duagen. (1,3) They’re essentially the same medicine — dutasteride is simply the generic name.
Dutasteride is also sold under the names Combodart and Duodart when combined with the drug tamsulosin in the same medication. Tamsulosin is an alpha-blocker also used to treat BPH. When combined, oral dutasteride-tamsulosin treats BPH with very positive results. (19) This combination has only been used to treat BPH and not hair loss.
What Is Dutasteride Used For?
Dutasteride was first used to treat benign prostatic hypertrophy (BPH), a condition causing prostate gland enlargement. It’s now approved as a hair loss treatment for androgenic alopecia in South Korea and Japan. (2)
Androgenic alopecia (pattern hair loss) affects up to 50 percent of men and women across the world. (4) Initial results show dutasteride could be effective in treating both male and female pattern hair loss. (5)
Although dutasteride for hair loss it isn’t yet approved in many countries, it’s widely used off-label with positive results. (6) Regardless of the form you choose to get dutasteride in, you should be aware that you’ll likely need a prescription from your doctor to obtain this medication.
How Much Does Dutasteride Cost?
Dutasteride varies in price depending on where you live and how you access your medication. In Japan, where dutasteride is approved to treat hair loss, prices average at JP¥11,500 for 30 pills. This is the equivalent of $104.52 USD ($3.40 per pill).
Dutasteride costs slightly less in most other countries. For example:
- In the US, dutasteride pills cost between $0.68 and $6.06 each.
- In the UK, prices range between £0.10 and £0.76.
- In Canada, prices range between CA$0.28 and CA$1.67 per pill.
Dutasteride is not yet approved as a hair loss treatment in these countries, but is still sometimes used off-label to treat androgenic alopecia.
How Does Dutasteride Work?
How Does Dutasteride Work?
Dutasteride is a dihydrotestosterone (DHT) blocker. It works by lowering levels of DHT, reducing the amount of DHT binding to the hair follicles. High levels of DHT is one of the primary causes of androgenic alopecia. (7)
DHT is a naturally occurring hormone derived from testosterone. However, in some people, it binds to hair follicles and progressively shrinks them, a process known as miniaturization. This shortens the hair growth cycle and causes thinner, weaker hair to grow. Over time, it can stop hair growth altogether. Hair follicle miniaturization can occur to both men and women. (8)
DHT is converted from testosterone by enzymes known as 5 alpha-reductase isoenzymes. There are three of these isoenzymes, which are simply called type 1, type 2, and type 3. Scientists think types 1 and 2 are the most significant for hair loss.
Dutasteride blocks all three types of isoenzymes indefinitely, stopping them from turning testosterone into DHT. (9) Research shows that a regular dose of 0.5 milligrams of dutasteride can reduce serum DHT levels by up to 92 percent and scalp DHT levels by up to 51 percent. (2) Lower levels of DHT in the body and scalp reduces the amount of DHT binding to hair follicles. This prevents further hair loss and gives healthy hair a chance to grow.
What Is a DHT Blocker?
DHT blockers work to reduce levels of dihydrotestosterone (DHT) in the body. DHT is a naturally occurring hormone present in both men and women. Testosterone, another hormone, is converted into DHT. DHT blockers stop this conversion process.
DHT is usually helpful, playing an essential role in male development. However, it binds excessively to some people’s hair follicles, causing them to shrink. In turn, this causes thinner, weaker hair and progressive hair loss. DHT blockers help to stop hair loss and allow hair to regrow over time.
There are two main DHT blockers used for hair loss: dutasteride and finasteride. Finasteride is FDA-approved. Dutasteride is only approved in Korea and Japan but is used off-label for hair loss in other countries. This medication is stronger and more effective than finasteride as it reduces DHT levels more significantly (7).
Finasteride and dutasteride are medications. However, that natural DHT blockers also exist. DHT blocking nutraceuticals are sometimes incorporated into supplements, shampoos, and. otherhair products.
Do Dutasteride and Finasteride Work in the Same Way?
Dutasteride and finasteride are the two main DHT blockers used to treat androgenetic alopecia. Both essentially work in the same way: by reducing levels of dihydrotestosterone (DHT) in the body to combat hair loss. However, there are small but very significant differences in their mechanism of action.
DHT is a hormone that is one of the main causes of androgenetic alopecia, the most common form of hair loss. (2) DHT is derived from testosterone, another vital hormone. In some people, DHT binds to their hair follicles, causing shrinkage and eventual hair loss.
Three 5-alpha reductase isoenzymes, known as type 1, 2, and 3, convert testosterone to DHT. Finasteride inhibits type 2 and 3, while dutasteride inhibits all three types. It’s important to mention that type 1 and 2 are thought to be the most important in preventing hair loss. Therefore, dutasteride is a more potent and effective DHT blocker. (9)
Dutasteride has a longer serum half-life than finasteride, which simply means it’s stronger and lasts in a patient’s system for longer. (10) Dutasteride binds to the isoenzymes irreversibly while finasteride doesn’t. This means dutasteride blocks their action indefinitely and, therefore, produces longer-lasting results. (10)
Dutasteride Effectiveness
Does Dutasteride Work?
Dutasteride is a highly effective dihydrotestosterone (DHT) blocker. It’s proven to have long-lasting results when treating androgenetic alopecia. (2)
DHT is a hormone that occurs naturally in the body and is usually useful. But in some people, DHT can bind to hair follicles, causing them to shrink. This leads to thinner hair and, eventually, can prevent hair growth, causing balding. DHT is one of the leading causes of androgenetic alopecia. This form of alopecia is one of the most common forms of hair loss and can be very distressing for those experiencing it. (2)
Dutasteride works by reducing levels of DHT to help reduce the chance of this binding process. This gives healthy hair a chance to grow and prevents further hair loss. Research shows that a dose of 0.5 milligrams per day of dutasteride can reduce DHT levels in the bloodstream by as much as 92 percent, and levels of DHT in the scalp by up to 52 percent. (2)
Recent studies show dutasteride is a promising treatment for female-pattern hair loss (the type of androgenic alopecia affecting women). A 2019 study showed a significant increase in both crown and temple hair density in women taking a low dose of dutasteride. (5) It also shows promise in treating frontal fibrosing alopecia (FFA), a form of hair loss primarily seen in postmenopausal women. (11)
How Long Does It Take Dutasteride to Work?
When taking a daily dutasteride dosage of 0.5 milligrams, patients typically start to see positive results such as a reduction of hair loss after an average of 3 months. After 6 months, patients usually notice significant changes to their hair, including increased hair growth and hair thickness. (12)
Dutasteride is a dihydrotestosterone (DHT) blocker that stops further hair loss, allowing healthy hair to grow. It’s important to remember that this is a long-term treatment, so patience and consistency are needed to see results.
How Effective Is Dutasteride?
Dutasteride is a very effective treatment for androgenetic alopecia. Patients taking dutasteride see significant, long-lasting prevention of further hair loss and promotion of healthy hair regrowth within 6 months. (12)
Dutasteride works as a DHT (dihydrotestosterone) blocker, lowering DHT levels in the body. DHT is a naturally occurring hormone made from testosterone. It’s one of the main causes of androgenetic alopecia. When DHT binds to the hair follicles, it causes thinner hair and hair loss. Dutasteride helps stop this process from occurring.
Three 5-alpha reductase isoenzymes work to convert testosterone to DHT. Dutasteride blocks all three isoenzymes, compared to finasteride which only blocks two out of the three. Dutasteride has a longer half-life than finasteride and binds to the isoenzymes irreversibly. This means dutasteride results are long-term, and the drug is more effective overall. (9)
A randomized controlled study found that men taking 0.5 milligrams of dutasteride per day over 24 weeks saw an impressive increase in hair growth and prevention of disease progression. Total hair count was increased by 23 cm², while thin hair count was decreased by 8 cm² .(12)
How Effective Is Topical Dutasteride?
Dutasteride is usually taken orally in daily 0.5 milligram doses. It’s not usually incorporated into topical products, like shampoos or hair oils, unlike many other hair loss treatments. However, it shows promise as a topical treatment. Topical dutasteride treatments have the potential to prevent hair loss and stimulate hair growth more than oral equivalents. (13)
Topical dutasteride is sometimes combined with other topical hair loss treatments, like finasteride and minoxidil. A pilot study of a lotion combining all three of these topical ingredients saw very positive results. Although the patient group was small, with only 15 participants, all patients saw a significant increase in hair growth. (14)
Dutasteride mesotherapy is another method of topical application. It involves applying micro-injections of dutasteride directly onto the scalp. Mesotherapy is minimally invasive, and while it isn’t yet widely studied, initial research shows it could be very effective. During mesotherapy, a combination of ingredients is typically used. For example, in one study, a preparation of dutasteride 5 milligrams, D-panthenol 500 milligrams, biotin 20 milligrams, and pyridoxine 200 milligrams was used. This combination increased hair diameter and thickness and reduced hair loss. Mesotherapy will typically be administered once every week to 10 days for a number of weeks to see results. (8)
In some studies, dutasteride was also injected alongside ingredients like biotin and vitamin B6. A trichogram analysis, which is a microscopic examination of hairs plucked from the scalp, was used to examine hairs following this treatment. When looked at under the microscope, researchers saw healthier hair strands. This showed that the results were even more effective than using dutasteride alone. (8)
Since topical dutasteride is applied directly to the scalp, it’s less likely to cause systemic side effects. However, mesotherapy treatments have their own side effects, such as scalp irritation and, paradoxically, hair loss in some cases. (8)
Dutasteride Side Effects
Does Dutasteride Have Side Effects?
Like any medication, dutasteride has potential side effects. The majority of side effects are related to sexual function. These sexual side effects may include a decreased libido, issues with ejaculation, and impotence. It can also cause gynecomastia, the enlargement of breast tissue, in some people. However, research shows that these side effects occur in less than 1 percent of patients. In general, dutasteride is well tolerated and safe for use. (19)
Dutasteride can affect the liver, as androgens play an important part in liver function. Other dutasteride side effects include swelling, depression, skin irritations, and fatigue. However, these side effects typically occur in less than 1 percent of patients. (19,20)
It’s important to remember that all medications have potential side effects. Being aware of them can help you to make an informed choice.
Does Dutasteride Have Sexual Side Effects?
Dutasteride has several potential sexual side effects. These include a reduced sex drive, ejaculation disorders, impotence, and enlargement of the breast tissue (gynecomastia). While these side effects can be distressing for patients, research suggests they only occur in as few as 1 percent of people taking 0.5 milligrams of dutasteride. (19)
Dutasteride is a dihydrotestosterone (DHT) blocker. It works to block excess levels of DHT from binding to the hair follicles. Oral dutasteride works systemically and affects androgens, known as male sex hormones. Therefore, in some people, it can result in sexual side effects.
It’s important to know the risks before taking any medication so that you can make the best choice for your health. A review of research on the topic found that over 2 years, the incidence of sexual side effects was only slightly higher in dutasteride-treated patients than among placebo-treated patients. (19) Interestingly, sexual side effects seem to decrease the longer the patient takes dutasteride. (2) Overall, dutasteride is thought to be a safe and highly effective hair loss treatment.
Will Dutasteride Cause the Same Side Effects as Finasteride?
Dutasteride and finasteride are the two primary dihydrotestosterone (DHT) blockers used to treat androgenetic alopecia. Dutasteride causes very similar side effects as finasteride as they both work in very similar ways. (21)
DHT is a hormone that can bind to the hair follicles, causing hair thinning and hair loss. DHT blockers work to stop this process and allow healthy hair to grow. Since DHT blockers work systemically on androgens (‘sex’ hormones), they can have adverse sexual effects.
Finasteride and dutasteride both cause sexual side effects, including lowered libido, erectile dysfunction, and problems with ejaculation. These medications typically cause similar amounts of side effects. A 2019 systematic review found no significant differences in the rates of side effects in patients taking finasteride or dutasteride for 24 weeks. (21)
Post-Finasteride Syndrome (PFS) is a condition affecting men who have taken finasteride, dutasteride, or other DHT blocking medications. Symptoms include adverse sexual, mental, and physical effects. (22)
PFS is a controversial topic, as most medical community members don’t recognize it as a ‘real’ syndrome. However, it’s very real for those experiencing it. More recent research emphasizes the need for this collection of side effects to be taken seriously to aid existing patients and better inform potential patients. (23)
Can Dutasteride Cause Prostate Cancer?
Dutasteride is a dihydrotestosterone (DHT) blocker used to treat benign prostatic hypertrophy and androgenic alopecia. Original research found that dutasteride and finasteride (another DHT blocker), can lower the risk of prostate cancer. However, they may slightly increase the risk of high-grade prostate tumors. (24)
Due to these findings, a warning is often present on the prescribing information that comes with these pills. However, more recent research suggests that there isn’t an increased risk of prostate cancer in those taking DHT blockers.
A meta-analysis on the topic found that there was up to a 37 percent decrease in the risk of prostate cancer in those taking dutasteride. There was also no significant increased risk of high-grade tumors. (24)
This misconception exists because dutasteride can mask the growth of tumours, leading to later detection. The issue isn’t that dutasteride is causing the tumor or cancer, but that taking this medication might prevent it from being detected until it has already spread.
Does Dutasteride Have Any Drug Interactions?
Dutasteride does have some potential drug interactions. A cancer treatment drug called ceritinib and an antibiotic called clarithromycin can both interact with dutasteride.
A range of other dutasteride interactions are possible, including with ketoconazole, which can also be used to treat androgenetic alopecia. (25) While this combination is generally safe, it may increase the risk of side effects. Make sure to check with your doctor about any drug interactions before beginning dutasteride treatment to ensure your safety.
Dutasteride Alternatives
Finasteride vs. Dutasteride
Both finasteride and dutasteride are dihydrotestosterone (DHT) blockers. They were initially used to treat enlargement of the prostate gland, known as benign prostatic hypertrophy. They later became hair loss treatments. Both finasteride and dutasteride are usually taken orally, although they are also available topically.
Finasteride and dutasteride work to reduce levels of DHT, therefore reducing the amount of DHT binding to the hair follicles, one of the main causes of androgenetic alopecia. Although they work in very similar ways, there are slight differences in their mechanism of action. Essentially, dutasteride is more potent and more effective than finasteride. (21)
Since dutasteride is more potent, it’s taken in smaller doses. Dutasteride is usually taken in 0.5 milligram daily doses. (2) Finasteride pills are typically taken in 1 milligram daily doses for hair loss.
Finasteride is approved by the US Food and Drug Administration (FDA) and other equivalent health boards for the treatment of androgenetic alopecia. Dutasteride is not yet approved by the FDA for hair loss. It’s currently only approved in South Korea and Japan. However, it has gone through many clinical trials in other countries, including Argentina, Australia, and America. (26) It’s also used off-label in countries where it is not yet approved as a hair loss treatment.
Both finasteride and dutasteride have similar potential side effects, including adverse sexual side effects. In general, both drugs are well tolerated, and research suggests they’re safe for use. (21)
Dutasteride often costs a similar amount to finasteride when used to treat hair loss. Many studies concluded that both DHT blockers cost around the same price per month in the USA. (27) How you access dutasteride and where you live will also have a significant impact on cost.
What Is the Difference Between Finasteride and Dutasteride?
Dutasteride and finasteride work in very similar ways, but there are slight differences in how they work. These differences make dutasteride more potent and, therefore, more effective at lower doses. (21)
Dutasteride and finasteride are both dihydrotestosterone (DHT) blockers. They both work to reduce levels of DHT. They do this by inhibiting the conversion of testosterone to DHT. This lowers levels of DHT in the bloodstream and reduces the amount of DHT binding to the hair follicles. DHT binding to the hair follicles is one of the main causes of androgenetic alopecia.
DHT is a hormone made from testosterone. Isoenzymes are chemicals that work to convert testosterone into DHT. Three isoenzymes play a part in this process. They’re known as 5-alpha reductase isoenzymes types 1, 2, and 3. Type 1 and 2 are understood to be the most important for hair loss. (8)
Finasteride inhibits the action of types 2 and 3 of these isoenzymes. Dutasteride inhibits all three types. It can be up to three times more potent at inhibiting the type 2 enzyme than finasteride. (14)
Dutasteride also binds to the isoenzymes irreversibly while finasteride does not. This means dutasteride continues to inhibit the action of the isoenzymes in the long term, producing long-lasting results. (10)
Oral dutasteride decreases DHT serum levels by up to 90 percent. In contrast, finasteride only reduces levels by up to 70 percent. Fundamentally, these differences mean that dutasteride is more effective at reducing DHT levels than finasteride. (8)
Can You Switch From Finasteride to Dutasteride?
Finasteride and dutasteride are dihydrotestosterone (DHT) blockers used as treatments for androgenetic alopecia. However, dutasteride is more potent than finasteride due to a slight difference in how it works. Some people choose to switch from finasteride to dutasteride because of this. (14)
Switching to dutasteride is generally considered safe. It’s also shown to be effective, especially for patients who weren’t showing clinical improvement while taking finasteride. But since finasteride is a long-term treatment, patients should try finasteride for at least 6 months before considering a new medication. (28)
If you intend to switch medications, be aware that it can take another 3 to 6 months before you see results from dutasteride. One study found that after switching to a 0.5 milligram dose of dutasteride for six months, patients experienced a significant improvement in hair density and thickness. (28)
Since dutasteride is a more potent DHT blocker, in some patients it can result in a higher incidence of sexual dysfunction. Therefore, it’s crucial patients are well informed before making the change.
If patients experience more side effects with dutasteride, they can switch from dutasteride to finasteride. For some, finasteride may be more suitable, particularly as this drug is FDA-approved. However, this switch may cause some hair shedding and less hair density over time. (29)
Are There Any Other DHT Blocking Alternatives to Dutasteride?
Dutasteride and finasteride are the primary dihydrotestosterone (DHT) blockers used to treat hair loss. Natural DHT blockers are also available, such as the popular nutraceutical saw palmetto. Saw palmetto is an extract that comes from the berries of a type of palm tree. Other nutraceutical DHT blockers include stinging nettle, pumpkin seed oil, lycopene, tea tree oil, and caffeine.
Natural DHT blockers are often incorporated into topical treatments such as shampoos, hair oils, and sprays. But research shows these alternatives aren’t as effective as dutasteride or even finasteride since they don’t lower DHT levels as much. (30)
Dutasteride Combination Treatments
Can You Combine Dutasteride With Any Other Treatments?
Dutasteride can be combined with other hair loss treatments. In some cases, these combinations may be more effective than dutasteride alone. (15) It’s important to remember that these combinations are not approved by the FDA or any other relevant authority. Consult your doctor before starting any combination treatment, as combining medications and even nutraceuticals may not always be safe.
Dutasteride and finasteride are the two main dihydrotestosterone (DHT) blockers used to treat androgenetic alopecia. The FDA has not yet approved dutasteride for use as a hair loss treatment, although finasteride is. Research shows that combining finasteride and dutasteride is safe and could be more effective than either treatment used on its own. One study of a 47-year-old man over a period of four years found that when 0.5 milligrams of dutasteride was added to his finasteride treatment, hair density increased significantly. (15)
Minoxidil is a hair loss treatment known as a vasodilator. It increases blood flow to the scalp, which widens the blood vessels and hair follicles. This allows thicker hair to grow. Minoxidil can be combined with oral or topical dutasteride. Research shows it could be an effective combination, with one study showing a total hair increase of 45.9 hairs per cm² .(17)
Ketoconazole is an antifungal medication that also acts as a DHT blocker. It binds to DHT receptors on hair follicles, preventing DHT from affecting them. It’s usually found in shampoos. Topical ketoconazole can be combined with topical dutasteride, and initial studies are promising as they seem to show that the combination could increase hair density and reduce hair loss. (14)
Patients may combine dutasteride with natural DHT blockers, such as saw palmetto, to try to improve their outcomes. Natural options may be taken as supplements or used topically while taking oral dutasteride. (30) It’s important to note these natural combinations are not well researched or proven to be safe.
Does Dutasteride Work Better When Combined With Other Treatments?
Dutasteride can be more effective when combined with other treatments. However, most of these combinations aren’t officially approved as safe. It’s important to do your research and consult your doctor before starting any combination treatment.
Dutasteride is a dihydrotestosterone (DHT) blocker. DHT binding to the hair follicles is one of the leading causes of androgenetic alopecia. Dutasteride is sometimes combined with finasteride, another primary DHT blocker. When the two are used simultaneously, research suggests they may be more effective than either DHT blocker taken alone. (15)
Minoxidil, an FDA-approved topical treatment, is also sometimes combined with oral or topical dutasteride. (14) Minoxidil is a vasodilator, which increases blood flow to the scalp and widens blood vessels. This increases the size of the hair follicles, allowing healthier, thicker hair to grow. (16) Minoxidil combined with oral or topical dutasteride shows promise as a hair loss treatment, with the potential to increase hair growth and hair thickness. (17)
Ketoconazole is an antifungal medication, often seen in topical treatments like shampoos. It has anti-androgenic properties and also works as a DHT blocker. It’s a receptor antagonist, which means it binds to DHT receptors, blocking DHT’s action.
Ketoconazole has been studied since 1992. Although new studies are limited, results suggest that a shampoo containing 2 percent ketoconazole is highly effective in treating hair loss. (18) Initial studies show ketoconazole shampoo could be effective when combined with dutasteride. (14)
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Last updated July 2021