Dutasteride vs Finasteride: Which is Best for Androgenetic Alopecia?
Noticing more hair in the shower drain? Facing a receding hairline? Millions of people are struggling like you while dealing with Androgenetic Alopecia, also known as pattern baldness. Two medications, Finasteride and Dutasteride, have shown promise in addressing hair loss by inhibiting the activity of an enzyme responsible for hair thinning.
But how do they compare, and which one is right for you? While Finasteride is a well-established option, Dutasteride may offer additional benefits as it blocks both types of enzymes that convert Testosterone to DHT, the hormone responsible for hair loss, as opposed to Finasteride, which blocks only one type.
If you’re considering these medications, it’s essential to understand their effectiveness, how they work, and what you need to know before starting treatment. For more detailed information, it’s recommended that you read this article that compares Dutasteride vs. Finasteride for hair loss.
The overview: Dutasteride vs Finasteride
The table below gives a concise summary of the important similarities and differences between the two medications:
| Dutasteride | Finasteride | |
| Mechanism of Action | Inhibits both type 1 and type 2 5-alpha-reductase enzymes | Inhibits type 2 5-alpha-reductase enzyme |
| Used for | Enlarged prostate (BPH) and male pattern baldness | Enlarged prostate (BPH) and male pattern baldness |
| Dosage | 0.5mg once daily | 1mg once daily |
| Half-life | 4-5 weeks | 5-6 hours |
| Side Effects | Decreased libido, Erectile Dysfunction, breast tenderness and enlargement | Decreased libido, Erectile Dysfunction, decreased semen volume, and breast tenderness |
| FDA Approval | Approved for Benign Prostatic Hyperplasia (BPH) treatment only | Approved for Benign Prostatic Hyperplasia (BPH) and male pattern baldness treatment |
Mechanism of action
Dutasteride and Finasteride both work by inhibiting 5α-reductase, the enzyme that converts Testosterone to Dihydrotestosterone (DHT). However, they differ in their selectivity and potency:
- Finasteride selectively inhibits type II 5α-reductase, while Dutasteride inhibits both type I and II isoenzymes
- Dutasteride is 3 times more potent at inhibiting type I and 100 times more potent at inhibiting type II 5α-reductase compared to Finasteride
Both medications limit their action on hair follicles by reducing DHT levels, the underlying cause of Androgenetic Alopecia.
Finasteride vs Dutasteride’s effectiveness
Finasteride and Dutasteride are both effective medications for treating Androgenetic Alopecia (AGA), but they differ in their success rates. This difference stems from how they target the enzyme responsible for hair loss.
The broader targeting of enzymes gives Dutasteride an edge in terms of effectiveness. Studies have shown that Dutasteride leads to greater total hair count and improved hair growth compared to Finasteride.
In a 24-week study, Dutasteride showed a higher increase in hair count than Finasteride. During the trial, 77% of men who took Dutasteride saw an increase in hair count compared to participants who took Finasteride or the placebo. Another meta-analysis found that Dutasteride provided a 7.1-hair/cm² increase compared to Finasteride’s 4.0-hair/cm² increase. However, it’s important to remember that Finasteride works for hair loss.
Finasteride medications, like Finalo, remain a widely used and effective treatment for AGA. Finasteride is a DHT blocker also, and long-term use of the medication has shown significant hair growth and stabilization of hair loss.
Side effects of Dutasteride and Finasteride
5-alpha reductase inhibitors Dutasteride and Finasteride have some key side effects, some of which are common and some different.
Similar side effects
The common side effects of both medications are:
- Sexual side effects: Erectile Dysfunction, decreased libido, and decreased ejaculate volume in 3.4-15.8% of men
- Psychological effects: Potential link to Depression, though direct causation is unclear
- Use in women: Limited data is available associated with Dutasteride or Finasteride for women, but potential risks include congenital disabilities in male fetuses, decreased libido, headache, and gastrointestinal discomfort
Differences in side effects
The Dutasteride vs Finasteride side effects, which makes them slightly different, include:
- Prostate Cancer: Finasteride may increase the risk of high-grade Prostate Cancer, while Dutasteride does not appear to have this effect
- Gynecomastia (breast enlargement): Dutasteride has a higher risk of causing Gynecomastia compared to Finasteride
Overall, both medications are generally well-tolerated, but you should be educated about the potential risks before treatment.
Precautions and interactions
This section discusses the precautions and interactions while using Dutasteride or Finasteride for hair loss.
Precautions
The main precautions to take when using Dutasteride or Finasteride include:
- Pregnancy and breast-feeding: Dutasteride and Finasteride should not be handled by pregnant women or women who may become pregnant due to the risk of congenital disabilities
- Allergic reactions: Both medications can cause severe allergic reactions, including trouble breathing, swelling of the throat or tongue, and hives
- Existing medical conditions: Individuals with liver disease or Prostate Cancer should consult their healthcare provider before using these medications
Interactions
There are some known interactions between Dutasteride or Finasteride and other medications. Dutasteride may interact with certain antibiotics, antifungals, and blood pressure medications, potentially slowing its metabolism and causing more of the drug to stay in the body than usual. Examples of drugs that may interact with Dutasteride include Ritonavir (an HIV drug), Amlodipine (a blood pressure drug), and Azithromycin (an antibiotic).
In fact, both medications can interact with other drugs, such as alpha-blockers, anticonvulsants, and blood pressure medications. However, Finasteride does not have as many known drug interactions. Nevertheless, informing your doctor about all medications you are taking is crucial.
Dosage and administration
Finasteride (Finpecia 1mg) is taken orally in tablet form at a recommended dose of 1mg daily, while Dutasteride is taken in capsule form at a recommended dose of 0.5mg daily. Both medications require consistent use over several months to show visible results.
Discontinuing the medication can reverse its effects. The hair loss prevention and regrowth benefits of Finasteride and Dutasteride are reversed within weeks to months after discontinuing the medications, as DHT levels return to pre-treatment concentrations. Regular use is required to maintain the therapeutic effects on pattern baldness.
FDA approval: Dutasteride vs Finasteride
While both Finasteride and Dutasteride are FDA-approved medicines, the approval is not for the same medical conditions.
Dutasteride is FDA-approved for Benign Prostatic Hyperplasia (BPH), a condition where an individual faces prostate gland enlargement. Although the FDA has yet to approve it as a hair growth medicine, it is still used as an off-label treatment.
On the other hand, Finasteride is an FDA-approved medicine for hair growth. It is approved for hair loss caused by Male Pattern Baldness and Benign Prostatic Hyperplasia.
Conclusion
Both Dutasteride and Finasteride are effective in treating hair loss when it is Androgenetic Alopecia by inhibiting the 5α-reductase enzyme to reduce DHT levels. Dutasteride, known for its higher potency and broader enzyme targeting, may offer a slightly higher hair regrowth and density success rate. It does, however, come with a higher chance of side effects, especially those that affect sexual health, and in the US, it is not approved for use in pattern baldness.
On the other hand, Finasteride is FDA-approved for treating Male Pattern Baldness and might be a safer option for individuals concerned about side effects. Despite the challenges associated with hair loss, treatments like Dutasteride and Finasteride provide hope and various choices for its management. Consulting a doctor is crucial to select the most suitable treatment.
Frequently Asked Questions
Which is better, Finasteride or Dutasteride?
Dutasteride appears to be slightly more effective than Finasteride in treating pattern baldness. Studies have shown that Dutasteride is better at reducing DHT levels and promoting hair regrowth, with a similar side effect profile.
Should I switch from Finasteride to Dutasteride?
Switching from Finasteride to Dutasteride for hair loss is viable if Finasteride does not provide satisfactory results. Dutasteride is a more potent 5-alpha reductase inhibitor that may be more effective but carries a higher risk of side effects. Consult a doctor before changing your medication.
Can Dutasteride regrow hairline?
Yes, Dutasteride can regrow hair by inhibiting DHT(Dihydrotestosterone), which causes follicular miniaturization. It’s potent, and studies show significant hair growth, but it’s not FDA-approved for this use. Consult a doctor to determine if it’s appropriate for you.
Does topical Finasteride work?
Topical Finasteride is an effective treatment for pattern hair loss. Studies show it can significantly improve hair count compared to placebo and provide similar efficacy to oral Finasteride like Finalo 1mg, but with lower systemic exposure (lower overall levels of the drug being absorbed into the bloodstream.)
