Jumping straight to Dutasteride?

[Captain Hook]

I've never been one to half-*** anything and if my Androgenetic Alopecia isn't controlled with my current regimen after 1 year then I will have no choice but to make a decision to start treatment with an oral 5-alpha-reductase inhibitor.

So that being said, is there any point in me trying finasteride first? I see a lot of anecdotal reports stating that people continue to lose hair despite being on finasteride. Wouldn't it make sense not to waste time and just begin the most potent option?

Are there any additional side effects that are of note regarding dutasteride versus finasteride?

As for dosing protocols, what's the consensus? With a half-life of 5 weeks, would taking 0.5 mg once or twice a week be a viable option?

 

[Wolf Pack]

Sup brah? I have not wrote a lot recently but thought I would respond to you. My opinion is try Finasteride first. Reason is because it does work for the majority of people and your hair loss doesn't seem aggressive genetically - at least that's my current impression. Why take on the increased risk of side effects from the stronger medication?You can always switch if finasteride isn't working too. If finasteride works well for you in the first year, you know you will respond long term as your body doesn't need a further DHT reduction.

The side effects for Dutasteride are the same as those for finasteride iirc, just more likely % wise. Then again some trials gave mixed answers. The side effect profile was as low as finasteride in one trial iirc, in one it was double, another trial had it much higher.

As for dosing, daily intake of at least 0.1 mg of dutasteride is superior to 5 mg of finasteride daily. That's according to the trials. Of course you can only get 0.5 mg liquid capsules of dutasteride. I think taking it 2-3 times a week would be better, bearing in mind its long half life which it will achieve once in a steady state. For peace of mind I would take it daily and for ease of compliance.

Another advantage of finasteride: there is a finasteride crew, no dutasteride crew

 

[DoctorHouse]

Sup brah? I have not wrote a lot recently but thought I would respond to you. My opinion is try Finasteride first. Reason is because it does work for the majority of people and your hair loss doesn't seem aggressive genetically - at least that's my current impression. Why take on the increased risk of side effects from the stronger medication?You can always switch if finasteride isn't working too. If finasteride works well for you in the first year, you know you will respond long term as your body doesn't need a further DHT reduction.

The side effects for Dutasteride are the same as those for finasteride iirc, just more likely % wise. Then again some trials gave mixed answers. The side effect profile was as low as finasteride in one trial iirc, in one it was double, another trial had it much higher.

As for dosing, daily intake of at least 0.1 mg of dutasteride is superior to 5 mg of finasteride daily. That's according to the trials. Of course you can only get 0.5 mg liquid capsules of dutasteride. I think taking it 2-3 times a week would be better, bearing in mind its long half life which it will achieve once in a steady state. For peace of mind I would take it daily and for ease of compliance.

Another advantage of finasteride: there is a finasteride crew, no dutasteride crew

Great advice. I agree.

 

[Captain Hook]

Sup brah? I have not wrote a lot recently but thought I would respond to you. My opinion is try Finasteride first. Reason is because it does work for the majority of people and your hair loss doesn't seem aggressive genetically - at least that's my current impression. Why take on the increased risk of side effects from the stronger medication?You can always switch if finasteride isn't working too. If finasteride works well for you in the first year, you know you will respond long term as your body doesn't need a further DHT reduction.

The side effects for Dutasteride are the same as those for finasteride iirc, just more likely % wise. Then again some trials gave mixed answers. The side effect profile was as low as finasteride in one trial iirc, in one it was double, another trial had it much higher.

As for dosing, daily intake of at least 0.1 mg of dutasteride is superior to 5 mg of finasteride daily. That's according to the trials. Of course you can only get 0.5 mg liquid capsules of dutasteride. I think taking it 2-3 times a week would be better, bearing in mind its long half life which it will achieve once in a steady state. For peace of mind I would take it daily and for ease of compliance.

Another advantage of finasteride: there is a finasteride crew, no dutasteride crew

Thanks for the comprehensive reply Wolfbrah! I suppose that certainly is a logical way to approach this. I'm just really 'greedy' for results if that makes sense and I know that with Androgenetic Alopecia, time is of the essence.

That being said I'll have a word with my dermatologist when I return to HK next month and see what her opinion is too (as I'm the type who needs the green light from a physician for such a move). She'll be the arbiter of this decision and if I leave that office with a prescription then you can be sure I'll fill it. I'll be overcome with impish joy to be able to add *Finasteride Crew* to my signature

For anyone wondering why I'm deciding to switch so soon into my treatment journey, the reason being is I feel that while my current regimen has thickened up my hair and slowed my hair loss to a moderate extent (50% less hair on my hands in the shower, 70% less hair on my pillow), it seems that certain parts of my scalp seem more sensitive to DHT than others. What I mean by this is while part of my hair has stabilised, my temples are still slowly thinning. It looks weird having thinner hair in just two areas of my scalp, even having bald temples and thick hair everywhere else would look more normal (à la Ewan McGregor or Orson Welles).

That being said, I'm glad I'm taking measures swiftly, I feel that waiting from April 2014 until the end of August 2015 was long enough to go without treatments. At least now I've been on ones that have at least slowed my Androgenetic Alopecia. Hopefully finasteride will put a stop to my Androgenetic Alopecia and if not it should at least slow it even more than my current regimen, with dutasteride being the drug of last resort come December 2016 if its implementation becomes necessary. I honestly can't imagine how some people wait 5 years and watch their hair deteriorate at the metaphorical hands of DHT without attempting treatment. I understand if their Androgenetic Alopecia progression was really slow but honestly over the past year I've seen my hair change way too quickly for my liking.

I'm aiming to start finasteride sometime in December 2015.

Great advice. I agree.

Your input is always welcome House, as I value your opinion greatly. Noted!

 

[DoctorHouse]

Hook, as someone who tried dutasteride but I did not take more than one per week along with finasteride the other days, I saw no benefit. Actually, I got worse still. And not only that I got gyno and weight loss was harder. Your hair loss is not bad enough to risk dutasteride's sides. Dutateride might get faster results than finasteride but I think after a few years they level out and the results become similar. I don't know if you want kids in the future but dutasteride could hinder that possibility. I used dutasteride as my last resort and it failed. I now have to get a hair transplant if I want to reach my goal. I am going to consult with Rahal and Erdogan.

 

[Captain Hook]

Hook, as someone who tried dutasteride but I did not take more than one per week along with finasteride the other days, I saw no benefit. Actually, I got worse still. And not only that I got gyno and weight loss was harder. Your hair loss is not bad enough to risk dutasteride's sides. Dutateride might get faster results than finasteride but I think after a few years they level out and the results become similar. I don't know if you want kids in the future but dutasteride could hinder that possibility. I used dutasteride as my last resort and it failed. I now have to get a hair transplant if I want to reach my goal. I am going to consult with Rahal and Erdogan.

Thanks House, I appreciate your testimony. I'll take that under consideration. I have a feeling my dermatologist is going to say the same too, especially since finasteride is the only 5AR approved for Androgenetic Alopecia whereas with dutasteride it is an off-label use.

Pertaining to the bolded text, it's funny, for those who are close to me they all know I have no desire to have children (It's just my current viewpoint, my mind could certainly change, that's what cryopreservation of sperm is for I suppose) and any damage to my fertility is actually a bonus for me as male oral/injectable contraception is something I've longed for. Could dutasteride really render me virtually sterile temporarily? I've only read of preliminary studies where it was combined with testosterone enanthate as part of an experimental male contraceptive regimen.

 

[Agustin Araujo]

Captain Hook,

I strongly recommend to follow the advice Wolf Pack gave: Try Finasteride first. It works well for the majority of the people.

Most men with male pattern baldness won't need Dutasteride since Finasteride itself is already so potent. Also, your Androgenetic Alopecia doesn't seem aggressive at all, and I sincerely believe you'd benefit greatly from Finasteride. And to be 100% honest with you Captain Hook, you should Finasteride as soon as you can. I personally would not wait one year and risk losing more hair with your current regimen of topical Spironolactone and using Nizoral shampoo. Those two topical treatments do help, though they're very weak compared to the oral 5-alpha-reductase inhibitors.

I'd take the plunge if I were you, and I hope all goes well if you decide to give it a go! :sun:

 

[Captain Hook]

Captain Hook,

I strongly recommend to follow the advice Wolf Pack gave: Try Finasteride first. It works well for the majority of the people.

Most men with male pattern baldness won't need Dutasteride since Finasteride itself is already so potent. Also, your Androgenetic Alopecia doesn't seem aggressive at all, and I sincerely believe you'd benefit greatly from Finasteride. And to be 100% honest with you Captain Hook, you should Finasteride as soon as you can. I personally would not wait one year and risk losing more hair with your current regimen of topical Spironolactone and using Nizoral shampoo. Those two topical treatments do help, though they're very weak compared to the oral 5-alpha-reductase inhibitors.

I'd take the plunge if I were you, and I hope all goes well if you decide to give it a go! :sun:

Aye, I was hoping you'd reply to this thread Agustin, seeing as you are on dutasteride yourself.

To make my allusion in my previous post more clear, I agree with you. There isn't any more time to waste, while my Androgenetic Alopecia has slowed, it certainly hasn't stopped like I would like it to. I've just booked an appointment with my dermatologist for Friday the 13th (ironic) of November.

Thanks for the vote of confidence by the way! I'm curious, were you on finasteride in the past? If so, after how much time is elapsed should one decide to switch from finasteride to dutasteride?

 

[Agustin Araujo]

Aye, I was hoping you'd reply to this thread Agustin, seeing as you are on dutasteride yourself.

To make my allusion in my previous post more clear, I agree with you. There isn't any more time to waste, while my Androgenetic Alopecia has slowed, it certainly hasn't stopped like I would like it to. I've just booked an appointment with my dermatologist for Friday the 13th (ironic) of November.

Thanks for the vote of confidence by the way! I'm curious, were you on finasteride in the past? If so, after how much time is elapsed should one decide to switch from finasteride to dutasteride?

Yes indeed!

Definitely start taking Finasteride as soon as you can. I'm glad to know you've booked an appointment with your dermatologist, hopefully they'll write you the prescription for the medication. When you ask for it, have them prescribe you generic Proscar, which are 5 mg tablets of Finasteride. You can take those tablets, cut them into fourths, and take 1.25 mg of the medication daily. It'll save you money using that method since the 1 mg tablets are expensive and they're considered 'cosmetic' in the pharmaceutical industry.

I have never been on Finasteride in the past and have never taken it before. I went straight to taking Dutasteride out of fear that Finasteride wouldn't have been strong enough. Looking back now, I think I would've done well on it if I used it instead.

 

[Captain Hook]

Yes indeed!

Definitely start taking Finasteride as soon as you can. I'm glad to know you've booked an appointment with your dermatologist, hopefully they'll write you the prescription for the medication. When you ask for it, have them prescribe you generic Proscar, which are 5 mg tablets of Finasteride. You can take those tablets, cut them into fourths, and take 1.25 mg of the medication daily. It'll save you money using that method since the 1 mg tablets are expensive and they're considered 'cosmetic' in the pharmaceutical industry.

I have never been on Finasteride in the past and have never taken it before. I went straight to taking Dutasteride out of fear that Finasteride wouldn't have been strong enough. Looking back now, I think I would've done well on it if I used it instead.

Will do, the pharmacy I go to is just a short walk from my dermatologist's office so I'll be taking the dose the same day if all goes well. Knowing her she'll probably write me a prescription for both and just tell me to fill whichever one is cheaper. Generic drugs in HK are extremely cheap, I wouldn't be surprised if 1 mg Finpecia for example would be comparable to Proscar, it would save me the step of purchasing a pill cutter as well.

I appreciate the input, I suppose I can always switch to dutasteride if I'm not satisfied after 1 year of being on finasteride.

 

[Agustin Araujo]

Will do, the pharmacy I go to is just a short walk from my dermatologist's office so I'll be taking the dose the same day if all goes well. Knowing her she'll probably write me a prescription for both and just tell me to fill whichever one is cheaper. Generic drugs in HK are extremely cheap, I wouldn't be surprised if 1 mg Finpecia for example would be comparable to Proscar, it would save me the step of purchasing a pill cutter as well.

I appreciate the input, I suppose I can always switch to dutasteride if I'm not satisfied after 1 year of being on finasteride.

Alright, fair enough. Nice to know generic drugs are quite cheap in Hong Kong, hopefully that will apply to the 1 milligram tablets of Finasteride since they are literally treated as cosmetic pills. And we all know anything considered cosmetic usually won't be cheap, like dental implants and hair transplants for example. I do agree if the 1 milligrams pills are neatly inexpensive, it would save from the hassle of purchasing a pill cutter and using one.

It will be unlikely Finasteride will fail since it works well for the vast majority of men who take it to inhibit DHT. Other than that, hopefully you'll maintain well, and even get regrowth from it!

 

[Captain Hook]

Alright, fair enough. Nice to know generic drugs are quite cheap in Hong Kong, hopefully that will apply to the 1 milligram tablets of Finasteride since they are literally treated as cosmetic pills. And we all know anything considered cosmetic usually won't be cheap, like dental implants and hair transplants for example. I do agree if the 1 milligrams pills are neatly inexpensive, it would save from the hassle of purchasing a pill cutter and using one.

It will be unlikely Finasteride will fail since it works well for the vast majority of men who take it to inhibit DHT. Other than that, hopefully you'll maintain well, and even get regrowth from it!

Thanks, I suppose I'll find out when the time comes, fingers crossed eh. Hypothetically, let's say I only achieve maintenance, do you reckon switching to dutasteride would result in a better chance of regrowth in that case?

 

[Agustin Araujo]

Thanks, I suppose I'll find out when the time comes, fingers crossed eh. Hypothetically, let's say I only achieve maintenance, do you reckon switching to dutasteride would result in a better chance of regrowth in that case?

Both 5-alpha-reductase inhibitors are great for maintaining hair. Dutasteride is better than Finasteride, not by a whole lot, though it is a little better. When it comes to getting regrowth however, both will basically give the same results.

The thing is since Dutasteride suppresses more DHT than Finasteride, it allows more hair to come back, hypothetically speaking. There was a study done though that men who took Dutasteride had more hair come back than those who took Finasteride.

 

[Captain Hook]

Both 5-alpha-reductase inhibitors are great for maintaining hair. Dutasteride is better than Finasteride, not by a whole lot, though it is a little better. When it comes to getting regrowth however, both will basically give the same results.

The thing is since Dutasteride suppresses more DHT than Finasteride, it allows more hair to come back, hypothetically speaking. There was a study done though that men who took Dutasteride had more hair come back than those who took Finasteride.

Noted, thanks! I guess I'll just have to see how I go

 

[Agustin Araujo]

Noted, thanks! I guess I'll just have to see how I go

Sure thing! I'm sure you'll do great on Finasteride, and your hair will maintain nice and well. :heart:

 

[whatevr]

The problem with dutasteride is the cost. With finasteride you can easily get the 5mg version and cut it and save a bunch of money, you can get a year's supply for peanuts.
But with dutasteride? 100 pills is something like several hundred dollars ffs? If you can't get it from your doctor which a lot of us can't as it's not approved for hair loss.
And inhouse and all those others don't ship here. Soo... I can't even imagine what I'm gonna do about that if finasteride fails.

 

[Agustin Araujo]

The problem with dutasteride is the cost. With finasteride you can easily get the 5mg version and cut it and save a bunch of money, you can get a year's supply for peanuts.
But with dutasteride? 100 pills is something like several hundred dollars ffs? If you can't get it from your doctor which a lot of us can't as it's not approved for hair loss.
And inhouse and all those others don't ship here. Soo... I can't even imagine what I'm gonna do about that if finasteride fails.

Not if you're living in the United States like I am. Dutasteride recently became generic in my country and costs $8 now with health insurance for 30 capsules, worth a month's supply. The best chances of getting the medication off-label for treating Male Pattern Baldness is if you can have a hair transplant surgeon prescribe it to you, they're the ones who are knowledgeable about hair loss and are the most understanding about those who suffer from the condition.

 

[whatevr]

Well in that case you brothers from the States would be doing us a huge favor to hook us up with some of that cheap dutasteride that you can buy.

Because here we can only get Avodart and 30 pills of the stuff costs 50 Euros, that is 55 Dollars. I should jump to dutasteride but I can't afford that stuff basically.

 

[Captain Hook]

@whatevr

It's not just the US that enjoys inexpensive dutasteride. Both generics and brand name Avodart are really cheap in HK too. Have you considered AllDayChemist? Their 1 mg finasteride is ~17 USD for 90 tablets, their 5mg finasteride is ~42 USD for the same amount and their dutasteride is ~59 USD for 90 capsules.

You're getting taken for a ride, you should really buy your medications online, especially if you decide to switch to dutasteride (of course after having discussed this with your doctor)

Also for some reason I've read a lot of anecdotal reports where people notice that dutasteride causes paradoxically less side effects compared to finasteride? Why is this? Since it inhibits not only Type II and Type III 5AR isoenzymes like finasteride, but also Type I, I've been conditioned to think the opposite for the longest time.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472914/

Even this PubMed review confirms the anecdotal evidence. With dutasteride having a 17% incidence of adverse events compared to finasteride's 20%. In addition, dutasteride showed lower percentages in every category of side effects except for gynaecomastia, where it had a 0.1% higher incidence compared to finasteride (when controlled for with placebo), which is probably statistically insignificant.

http://www.ncbi.nlm.nih.gov/pubmed/24411083

As well as this study showing that dutasteride treatment results in higher hair counts.

In light of these two studies, in addition to my original fervour, part of me still wants to just start on dutasteride if my dermatologist approves. I'd much rather be on the strongest available treatment and then just have Androgenetic Alopecia out of sight and out of mind, without any worry if finasteride isn't enough.

 

[TransientHair]

You're getting taken for a ride, you should really buy your medications online, especially if you decide to switch to dutasteride (of course after having discussed this with your doctor).

I disagree. If you are buying online then you're always going to question whether or not you're getting legitimate medication. I have to wonder if the people who claim to lose ground on Dutasteride are actually using the real thing, as it just seems so unlikely considering how much DHT is being inhibited.