Have You Prescribed Avodart?

Dr. Rassman,
I came into your office aproximatley 14 months ago because I was frustrated with my hairloss. At that time I had been taking propecia for 7 months ( I was 22 at the time). For the next few monhts my hair loss seemed to stabilize but then I began law school and it appeared to accellerate again. I wear my hair very short, so I can see where it is thinning. I would like to know what you would suggest. I know that you are weary of avodart but have you prescribed it or do you know physicians in the area that will?Though I realize taking it presents somewhat of a risk to my health, I would like to do so under the guidence of an MD rather than on my own. I would appreciate any input you could offer or any suggestions for what I should do about my hair loss going forward. thank you

Avodart (dutasteride), aside from not being FDA approved as safe to treat hair loss, has a very long half life. The half life is defined by how long it takes for your body to remove half of the drug. The half life for blood levels is easy to measure (Avodart has at least 5-7 weeks half life in the blood stream), but there is also drug bound to the receptors in the various organs which will hold on to the drug for a much longer period of time. The experience with Avodart is in the field of urology, where it is used to treat various prostate problems. Men over 50 have most of the prostate problems, so men over 50 get most of the prescriptions written for Avodart. We do not know what would happen to young men on this drug for many, many years and we do not know if the sperm has the drug bound to it. If a sperm cell had Avodart in it, would it be found in a fetus fertilized by this sperm cell? I don’t know. With a very long half life, this is a good question from my perspective. Like the Vioxx toxic side effects that came on late, there was good statistical data available to suggest safety, even if it was not finally proved safe. But for Avodart, we do not have good statistical data for the chronic use in young men, so safety is not a proven fact. With Propecia, we know (because the drug company did the homework) that it is safe. The manufacturers for Avodart have been reluctant to study the safety issues for hair loss and this worries me. I guess I am not that trusting.

Another visit to me would be helpful. Let’s map out your scalp for miniaturization and see just what we are dealing with. I am not against prescribing Avodart under certain conditions on a patient-by-patient basis.