Adding Avodart Once a Week to My Daily Propecia?
Doctor Rassman, I am sure you get this questioned asked alot, but in your opinion as a hair restoration expert, do you think by adding 0.5 mg avodart once a week to a every 1 mg propecia regimen can make a difference in loss of hair or even gain?
There was a study of a an individual who took one avodart pill once a week to a propecia everyday regimen and he saw substantial growth. The study was only on one person, but its not a conicidence that it happened when he added the low dose of avodart once a week? or do you think avodart and finasteride at the end of the day still produce the same outcome? I know at the 2.5mg it produces the best results, put more of a high side affect profile, and very expensive.
Both Avodart (dutasteride) and Propecia (finasteride) work in a similar mechanism by blocking the formation of DHT, but I have often stated that treating androgenic alopecia is not only about blocking DHT. I do not believe if you block DHT 100% you will stop or reverse the balding process.
I’m not sure which study you’re referring to, but if it was an anecdotal report on ONE patient, it isn’t something I would put a lot of stock into. Please note that just because there is study results available, it doesn’t necessarily make it the golden truth. Now with that said, many doctors believe Avodart is a better medication for stopping hair loss than Propecia, but I am concerned about sexual side effects and the few reports of sterility that came from Avodart.
A few patients that I treated with Avodart did get a response after Propecia stopped working as well for them. That is as much as I know. I couldn’t tell you if adding a single Avodart dose per week will make a difference, though.
if blockking dht will not stop the balding process then what it the point of even taking a dht blocker? no matter what haurloss will still happen so why even take it?
I was almost 22 when I started Propecia for early hair loss…now I’m gonna turn 27 this year still got all my hair. I delayed MPB for almost 5yrs now…hopefully more years to come…i’d rather lose it years later because if I didn’t use Propecia who knows where I would’ve been now. I got to enjoy 5 years now of a full head of hair. Bottom line…wouldn’t you want to postpone MPB if you could?
Because it slows down the hairloss in many men and slowing down hairloss can be valuable to many of us.
Propecia or avodart are not cures but if something is not 100% effective does that make it worthless?
Besides propecia does halt and even reverse hairloss in some men so its usually worth a shot.
Dr. Rassman, why do you think 100 % DHT blocking will not stop the balding process?
I recall a study by Hamilton stating the opposite
The objective is not really to stop the balding process forever. That is not necessary.
The objective is to stop the process throughout one’s natural life. Or to slow it down enough so that hair transplants + the patient’s remaining natural hair give a look of having hair that is acceptable to the patient and /or even makes the patient happy!
Propecia / avodart, as well as minoxidil, are useful for this purpose and therefore should be part of one’s strategy to attain the desired cosmetic effect – the look of having a good head of hair that the patient is happy with.
I somewhat disagree with you. Yes, the objective is to slow down the balding process but it is also to completely stop it forever and hopefully grow hair. I am sure more men out there would rather have a complete cessation of hair loss then just slow it down and eventually become bald in the future and require to spend copious amounts of money on a hair transplant. I have seen a few people who have gotten a HT done and it isn’t to pretty unless the individual has a lot of native hair still present and can blend it in well with the transplanted hair. I don’t understand why people would spend money to get a HT when they hardly have hair to begin with and the results will still make them look thin and see thru. But that is a convo for another day.
I have been on propecia for quite some time now and it has done its job, even on the hairline, up until the past few years where I have noticed my hairline thinning considerably. The crown is still somewhat thick. In a perfect world, I would rather the propecia completely stop all that hair loss that I am experiencing then just slow it down.
My only question regarding avodart is, they have done enough clinical trials why are they still delaying this drug and not speaking openly about how many individuals got side effects and how serious they were. I also want to know how effective the drug is and when are they gonna officially approve the damn drug for MPB. If doctors are prescribing this medication sort of as an off-label use for MPB, isn’t it time they marketed it so everybody can use it.
“…but I am concerned about sexual side effects and the few reports of sterility that came from Avodart…”
This is reasonable, but then why do you rubbish similar claims and reports about finasteride?
Grant, just a question, have you tried adding minoxidil into the mix?
Just wondering. I am currently having success with these medications, but I have been taking both together from the outset.
I’m just wondering if minoxidil can kick hair growth back into gear if propecia by itself starts losing its effectiveness.
James – I don’t think dr rassman has entirely rubbished claims about propecia, he’s regularly said about 1-2% of men can expect sexual side effects from propecia which is stated in the literature and tallies with his experienced reports in his clinic.
Avodart blocks more forms of alpha reductase as I understand it and so it is more likely to cause adverse and longer lasting sexual side effects (as it also has a much longer method of action than finasteride) so it’s very tricky to get avodart right for what may be only a slight improvement or no difference to hair loss.
I don’t think anyone is claiming finasteride is 100% side effect free – it’s a powerful anti-androgen drug so its bound to have some side effects but like most drugs there is a balance made and chosen between effectiveness versus risk. Avodart seems to exceed that ratio.
I am one of the people who alos read about that study which was posted here on balding blog.I did it and add 1 capsule of Avodart per week to my current regiment of daily Propecia 6 months ago.(I took Avodart on Mondays,Propecia of other days).sadly I didn’t notice any difference in my crown.BUT I did notice significant INCREASE of libido.I was expecting decrease of libido but no it actually gave me so much boost in libido.I will stop using it though,cause it’s too expensive and not proven completely safe.
I did try minoxidil in conjunction with finasteride a few years back and I found that i was losing hair as well as growing small fine vellus (I think) hairs in the front hair line. I know it sounds weird but that is what happened. The small vellus were not even worth using the minox for because I was losing hairs as well. They could have been going through a phase and were eventually gonna be replaced but I didn’t want to take chance. I stopped the minox and just continued with the finasteride. I didn’t really have to use the minox in the crown because it was and still is relatively thick. If you read the reports on minox they even say it doesn’t help in the front of the head and is mostly for the crown and sometimes mid-scalp.
From what I have read about avodart it seems to be more effective in the crown if you are losing hair there but also effective in the front. I think its worth a try now.
Have you or will you also be trying avodart in the near future?
Hmm, interesting. I too was losing hair when I first went on the propecia / minoxidil combo. But I guess I was a bit more fatalistic about it than you at that point. About 3 years ago, my hair loss, which was progressing at a pretty moderate pace so I didn’t let it worry me to much…had finally stepped up into high gear. I went to visit a prominent hair loss doctor in NYC who basically told me I was going bald. I saw my hair under that microscope thingy the hair loss doctors use to determine miniaturization. The doctor was right. The hair all over the top of my hair was miniaturizing, meaning that in time, without intervention, I would be losing my hair there.
I had to come face to face with the fact that I have MPB. I have androgenic alopecia, the genetic condition that causes hair loss.
I didn’t and don’t want to lose my hair. So I did a lot of research and realized that this is a long term battle if you have androgenic alopecia and want to have hair during the course of your life.
I bit the bullet and made the decision to go on both finasteride and minoxidil. It was a tough decision to make and a very painful time in my life but if I that was my destiny…if I had the genes and was going to lose my hair anyways…then I had to come to grips with it and use everything that was scientifically proven to combat the process. And as we all know, this is a decision for good…for the rest of your life. This is how these medications work. You must take them for the rest of your life. And that is the choice I made and continue to make every day.
I noticed that when I first started putting minoxidil on my head that I did experience a “shed” of sorts. But not really. My hair was already falling out, on the pillow, in the shower, etc. After all, I was losing my hair. So when I rubbed minoxidil on my head, I would lose more hair, but I think that is just because of the friction of rubbing minoxidil on the already weak hairs that were falling out anyways. I noticed that I had a lot of hair on my hands when I rubbed in the minoxidil, but that they looked like smaller and thinner hairs. It was apparent that I was loosing the smaller and thinner hairs that were probably falling out anyways.
Things got a bit worse for about a month but…was it really a minoxidil shed? I was shedding my hair but heck…I was losing my hair! That is what happens when you lose your hair, you shed! But within 6 months, I did see a difference and a marked improvement. The “minoxidil shed” (if there ever really was such a shed, or if it was really just that the hair that was falling out anyway now had minoxidil all over it!) stopped within the first month, as the weak hairs all fell out and that was it. Since then, it has been steady improvement, and I have reverted back to about a Norwood 2 after almost three years of medical treatment.
I am keeping avodart, as well as hair transplants, on the back burner should I need them. This is a long term, lifelong battle after all. But so far, all seems well. If I do decide to pursue the use of dutasteride and/or hair transplants, it is a decision I will make in concert with my IAHRS approved hair loss doctor.
But going forward, I will continue using both minoxidil and finasteride, as they have been giving me very good results.
It was NOT simply anecdotal evidence. Yes, it was a case study of ONE person but he was monitored and the study paper actually included photographs taken. The person was in his late 40s and has been taking finasteride for 4 years, which did help him maintain and give slight regrowth. (Pictures show his crown before, after 2 years of finasteride and 4 years of finasteride) At the 4 year mark, he was clearly losing ground again so they have him take one additional 0.5 mg pill of dutasteride once a week. After 4 months, the photo shows some great regrowth! The study authors speculate it was the additional blockage of the type 1 enzyme and they also speculate the results might be the same if you just stop taking finasteride and take dutasteride once a week.