Dutasteride vs Propecia

Is dutasteride better for treating hair loss than Propecia?

In the Journal of the American Academy of Dermatology (Volume 55, Issue 6, December 2006), a 24 week randomized placebo-controlled study compared the two medications. DHT levels went down and testosterone levels went up on dutasteride. The results of this limited study suggested that in high doses, dutasteride had more hair growth than Propecia (finasteride). A total of 416 men were tested. There were more side effects on the higher doses of dutasteride.

This question has come up over and over again. We are waiting for the results of the Korean study to understand the meaning of the above publication. To get to the root of the question of effectiveness, we must know the results of dutasteride over a long time period and we must know the risks. There are reports of not only increased side effects such as more impotence or decreased libido, but there is also a significant impact on sperm count and possibly fertility in men. As there is a long half life of the dutasteride, the reversible nature of decreased sperm counts are not known. I would not suggest that every person rush to get this medication unless Propecia is a failure and there are reasons for trying the alternative. Please note that dutasteride is FDA approved to treat the prostate (marketed as Avodart), but it is not approved to treat hair loss, so it would be off label for the doctor to prescribe it and most doctors will not take the medical-legal risk for this off label use.