Dutasteride vs finasteride

[sneakyp]

I'm 22 and about to do something about my thinning hair. Can you guys tell me the pros and cons of dutasteride and finasteride? thanks

 

[iamnaked]

Finasteride is cheaper.
Dutasteride is better at preventing the production of DHT as it blocks both type I and type II Alpha Reductase. (see studies for the exact %, I think its like 75% vs 50%)
Dutasteride has a longer halflife - this means that if you are going to get side effects, it could be longer before they disappear if you're on dutasteride compared with finasteride.
The principle by which both work are similar. Some people have complained about sheds and sexual dysfunction on these two, but the level of truth in these claims is open to question. I have been on dutasteride for about 2 months now. I can happily report 0 side-effects.
Hope I've not missed anything.

 

[Cornholio]

Can you guys tell me the pros and cons of dutasteride and finasteride? thanks

I think the most important thing to say is that if you are starting hair loss treatment and have not taken either start with finasteride. It is cheaper (take 1/4 of a finasteride 5mg each day), has a shorter half life (it will be out of your system in days rather than months if you need to stop it due to side effects) and it has good proven efficacy.

Side effects are relatively infrequent for most with either drug. Sexual dysfunction is at or less than 10% for each, meaning you probably wont get it, and it should go away if you stop it. Gynocomastia (growing breasts : ) is 1% with finasteride, about 2% with dutasteride and may go away if you stop it (stop either if you get breast tenderness).

Finasteride blocks the type II testosterone to DHT converting enzyme which is most strongly related to hair loss, reducing serum DHT levels by about 70%, and scalp DHT levels by significantly less. Dutasteride lowers serum DHT levels by more than 90% and scalp DHT levels by more than 70% due to its blockade of the type I and type II enzyme... This may or may not help or cause greater efficacy, however, as the role of type I blockade in hair loss is opened to debate due to lack of good studies.

The phase II Avodart trials showed very similar regrowth at 6 months when comparing dutasteride .5mg and finasteride 5mg. At higher doses of dutasteride 2.5mg/day new hair growth was about 30% more than finasteride, and investigator assesment was a little better. Unfortunately, however, there are no longer term studies to show if dutasteride's better suppression of DHT at either dose results in much better clinical regrowth or maintenence, and there are certainly no studies of safety/efficacy for dutasteride at doses higher than .5mg for more than 6 months (which is where dutasteride showed possible marginal superiority over finasteride). So, at .5mg dutasteride the phase II Avodart studies suggest that dutasteride has slightly better supression of DHT but very similar clinical response to finasteride. Longer studies are lacking.

In short finasteride studies suggest it provides most of the benefits of dutasteride... dutasterides theoretical superiority and marginal clinical superiority is not well studied and is probably not worth the extra expense and risk (as above) for most people. It remains an option IF/WHEN you come to understand and accept the risk/benefits.

 

[maintainence1]

I would definately start with Finasteride. Dutasteride may have potentially serious side effects because it blocks type I alpha-reductase. Some people believe there could be neurological side effects from Dutasteride since there is type I AR in our brain tissue. I wouldn't risk the serious side effects of Dutasteride. Everyone wants to help their hair loss situation as much as possible, but there are some aspects of one's health that you shouldn't mess around with.

 

[Bryan]

Finasteride blocks the type II testosterone to DHT converting enzyme which is most strongly related to hair loss, reducing serum DHT levels by about 70%, and scalp DHT levels by significantly less.

I thought you wrote a VERY good and accurate general review of finasteride and dutasteride, with the single exception of the sentence above. I want to remind everybody that we don't really know for sure how much finasteride and dutasteride reduce DHT levels in the scalp, because there's conflicting information about it. A recent study by some big names in the field of dermatology found that finasteride reduces scalp DHT by almost exactly the same amount as it does serum DHT, contradicting the statement above.

Bryan

 

[Cornholio]

[A recent study by some big names in the field of dermatology found that finasteride reduces scalp DHT by almost exactly the same amount as it does serum DHT, contradicting the statement above.

Bryan

Bryan, I hope that is true, especially if dutasteride decreases scalp DHT by the same amount as it reduces serum DHT . (about 70% for finasteride, and 90%ish for dutasteride?)...although, admittedly, the significance for hair maintenence/regrowth due to those debatable numbers is unknown. Im just doing what I can.