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    I Was Responding to Finasteride, But I See More Loss Lately — Should I Switch to Dutasteride?

    Jun 12, 2014/by William Rassman, M.D./8 /Drugs

    Dr. Rassman and co,

    Thank you so much for this blog, it is a great source of information and truth.

    My question to you: I am a very good responder to finasteride, have been on it since 2010. I have recently been losing more and more hair especially from my temples and hairline. Would you think or recommend that i switch to dutasteride?

    Also i added Rogaine foam since 2012 and have noticed only slight results and maybe even some accelerated losses from the hairline and temples.

    Thank you

    The decision to switch to dutasteride is one that should be made between you and your prescribing doctor. I rarely prescribe dutasteride, however, when I do prescribe it, I usually require the patient to have had a course of finasteride first. I would allow a switch to dutasteride only on a case-by-case basis, so I can’t recommend it for you (especially because you’re not my patient and I don’t have your medical or hair loss history).

    Tags: avodart, dutasteride, hairloss, hair loss, finasteride

    Reader Comments8

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    1. advit
      advit says:
      Jun 12, 2014 at 11:46 am

      I am in the same situation. If I haven’t had any side effects from long term use of finasteride but find the drug is losing its effectiveness, if I switch to dutasteride will I get side effects?

      Reply
    2. Rory
      Rory says:
      Jun 12, 2014 at 1:55 pm

      I understand and respect Dr. Rassman’s reluctance to prescribe Dutasteride for off-label usage. Some doctors specialising in treatment of hair loss will however do so.

      Anecdotally, I also experienced decreasing efficacy of daily finasteride as I aged and my genetics asserted themselves. I switched to Dutasteride and have had great success with the medication.

      An additional benefit is, the extremely long serum life of the drug vs. finasteride allows one to take just a few capsules weekly vs. every day once ones hair loss has stabilised.

      I’ve experienced no side-effects of any kind on either of the medications, btw.

      Reply
    3. advit
      advit says:
      Jun 12, 2014 at 3:38 pm

      Hi rory,

      What are the dosage amounts for dutasteride. If your hair loss has not stabalized and what are the dosage amounts if your hair loss has stabalized?

      Thanks

      Reply
    4. Rory
      Rory says:
      Jun 12, 2014 at 10:06 pm

      0.5mg/daily is the generally accepted dosage, though as I’ve noted the medication is currently off label for hair loss. There are several generics available, Avodart is the American brand name medication.

      Reply
    5. advit
      advit says:
      Jun 13, 2014 at 1:25 am

      Rory,

      I didnt know they sold avodart in 0.5mg, I thought I was 1.0mg or higher? I also read recently that avodart wasnt effective in the hair line or temples just the mid scalp and crown. And, it wasnt much more effective then propecia in those areas. Is it worth it to switch even though side effects are much worst with avodart?

      Reply
    6. O-Qua Tangin Wann
      O-Qua Tangin Wann says:
      Jun 13, 2014 at 9:43 am

      I would urge anyone considering taking Avodart to not gamble with either the generics from any outside of USA country, or even the claimed originals from places like Turkey.

      I have been on Avodart for hairloss for years. I tried to save the money and noticed an absolute change in effectiveness when I was not taking the USA version of original Avodart.

      I can tell you that I have had considerable results for crown hairloss when taking the USA original version of Avodart. (I switched to Avodart years ago after noticing a lowering of effectiveness of Finasteride.) I take one Avodart pill daily. I have not experimented by taking a few pills per week rather than one daily as Rory wrote about in a comment above.

      Good luck to everyone that tries Avodart.

      Reply
    7. Rory
      Rory says:
      Jun 13, 2014 at 12:56 pm

      Avodart is available in a 0.5mg dosage, yes. Dr. Rassman has linked to studies from this site in which dutasteride at this dosage was demonstrated to be markedly more effective than 1mg finasteride. A 1.5mg daily dosage of dutasteride was even more effective, but a Avodart régime at this dosage would be quite expensive (US$350/monthly retail in my area) and would presumably increase side effects risk accordingly. Long-term studies have not been done.

      I have also always been wary of overseas generics. Presumably medication sourced from a legit Canadian pharmacy, requiring a proper MD scrip, would yield vetted, quality product at substantial savings — but I have not gone this route.

      My own transplant doc takes two 0.5mg Avodart capsules once weekly; I take 1 every 3 days, so same basic dosage. I have noticed no decrease in efficacy these past 2+ years having made this change. I am in my 40s and my final loss pattern has emerged, I’ve had a HT to entirely repair my concern areas, and am now in what I’ll call maintenance mode. A younger man experiencing aggressive loss might well have different goals.

      Reply
    8. advit
      advit says:
      Jun 13, 2014 at 1:51 pm

      Hi O-Qua Tangin Wan,

      Did you notice it helped in the hair line or temple areas. That is where I have the majority of my hair loss.

      Reply

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