My Doctor Prescribed Me Avodart and I Don’t Care About Side Effects
Good afternoon Doctor. To make a long story short just want to say I am a 28 year old male with early hair loss, and my derma gave me an rx for the drug avodart to stop hair loss. He didn’t give finasteride as he said its weak, and avodart is better. he told me about all the side affects of both drugs such as erection problems, gyno, low sperm count with avodart, etc. and basically said its my decision to pick which one, propecia or avodart so I choose the more effective one. I honestly do not care about the side affects, I’m single and I could care less if I have erection problems from avodart. My hair is more important than sex lol.
But anyways my question is that does avodart from clinical experience and studies does it work on hair loss better, or its about the same as propecia? The reason I’m asking is because avodart is more expensive, so if it the same as propecia might as well take the cheaper one. My dermatologist said it blocks type 2 5AR way better than propecia, and that the type 1 blocking ability of it will do nothing for hair loss as type is negligible and not proven to cause hair loss. From your practice, are the patients that take this drug doing better than the ones on propecia?
My first choice for a drug treatment is always finasteride (Propecia) and in the generic form it costs about $3/month. So yes, while Propecia is probably the cheaper option, it is also the only oral drug approved at this time by the FDA for the treating genetic hair loss (the other is topical minoxidil).
There haven’t been a ton of studies comparing the two for treating hair loss, but the one study that stands out in my mind is from late 2006, where 416 men were studied over 24 weeks. The results showed dutasteride was more potent and resulted in a superior hair growth count based on photos. But that is just one study over six months time, published nearly seven years ago.
One does not have to give up their sex life, nor does one have to take crazy risks with this decision. The incidence of sexual side effects from finasteride is 1 to 2%. Avodart (dutasteride) might work better in some men, but the side effect risk is much higher. I would criticize your doctor’s view on these two drug choices, and will point out that you are welcome to get another doctor’s opinion. Some doctors who do not specialize in these areas may not have all the information.
Just need to chime in on this one quickly.
While dutasteride is a stronger drug with a higher incidence of side effects, I think the evidence shows that the drug still is pretty safe and has a pretty low incidence of side effects. A low incidence of sexual side effects overall. The full text of Olsen study you just cited can be found pretty easily on the net by googling the phrase “avodart vs propecia.” If you look at the study, the evidence suggests the drug is pretty safe if you just look at the findings of the study.
Still, the drug just may not be necessary for most men. I believe most men do just about as well on propecia, and it has a lower incidence of side effects. I for one am taking propecia. If the effects ever wear out, I can then upgrade to the “big guns” of avodart and hair transplants if need be.
Also, I don’t think anyone has ever done the study comparing the effects of “propecia + rogaine” to “avodart” It could be that the combination of propecia and rogaine has effects similar to, or that surpass, the effects of avodart alone. So this — propecia + rogaine — should also be seen as an option.
I’ll offer my 2 cents here as well. After 6 years of reasonably successful results on Propecia, I switched to Avodart as my genetics apparently further asserted themselves and I began to visibly lose ground against the hair loss. After 5 years on Avodart I am extremely satisfied, the thickness and quality of the hair is greatly improved and I never see a hair on the pillow, in the drain, etc. No sexual or other side effects with either drug, btw.
This is a brief summary of the safety results reported in the Olsen (2008) study, which evaluated 416 men (21 to 45 years old) who were randomized to receive dutasteride 0.05 (n=71) , 0.1 (n=72), 0.5 (n=68) or 2.5 mg (n=71), finasteride 5 mg (n=70), or placebo (n=64) daily for 24 weeks. More detail is available by reading the actual article, published at https://www.ncbi.nlm.nih.gov/pubmed/17110217
In total, 11 subjects withdrew because of side effects: 3 were in the placebo group (irritable bowel syndrome and impotency), 7 in the dutasteride 0.1 mg group (decreased libido, malaise and fatigue, mood disorders, skin disorders, injuries caused by trauma, and gastrointestinal- and neurology-related complaints) and 1 in the dutasteride 0.5 mg group (gastrointestinal discomfort and pain). To sum, ALL groups had a low incidence of discontinuation in the study due to side effects but the incidence was numerically higher in patients receiving dutasteride compared with placebo or finasteride (although not statistical significantly different).
When sexual side effects were examined, decreased libido was noted in 2 subjects in the placebo group, 2 subjects in each of the 0.05-mg and 0.1-mg dutasteride groups, 1 subject in the 0.5-mg dutasteride group, 9 subjects in the 2.5 mg dutasteride group, and 3 subjects in the finasteride group. To sum, ALL groups had a low incidence of sexual side effects but the incidence was higher in patients receiving dutasteride compared with placebo or finasteride.
The only subject to develop gynecomastia was in the placebo group.
My typo above: the Olsen study was published in 2006, not 2008.
does dutasteride work better because of its ability to block more type 2 5ar or type 1 5ar as well? when merk tested there specific type 1 5ar inhibiyot (mk 386) it did nothing for hairloss. PLus the pesudohermaphrodites all had normal levels of type 1 5ar, with normal testosterone levels and still no hairloss or prostate problems.
Rory:
What dosage of avodart are you on right now and how many times a week do you take it. I am just trying to get a sense of what the dosage amounts are because I might need to switch to avodart soon.
Rory:
Forgot to ask if you experienced a massive shed or anything shedding at all. I know a lot of pple shed when they switch from propecia to avodart and that hair never grows back.
My understanding is that Avodart does perform significantly better at reducing serum DHT overall. Its long half-life, measured in weeks vs. hours for Propecia, may also represent an advantage.
I take 0.5mg every 3 days, essentially twice per week, and this has been extremely effective for me. My HT doctor himself takes 1mg once per week and has also had very good results.
rory had you experienced any shedding from avodart? do you still take propecia? IM thinking of adding avodart to my propecia regimen. im just scared by coming off propecia I will lose propecia benefits? any truth to that? I know avodart does propecias job way better, but just scared off dropping propecia. thinking of taking 1mg propecia every day still and adding avodart every other day.
I had no significant shedding issues. I switched to Avodart from Propecia, it did not make sense to me to worry about losing benefits of a less effective medication when starting a stronger one.
There have been posts on Dr. Rassman’s site discussing adding Avodart to a Propecia regimen, you might do an archives search for those. Personally, the Avodart has been much more effective, and I am taking much less medication for increased benefit; so for me it’s a no-brainer.