Dutasteride : Super drug against Genetic hair loss than Finasteride
Many of my patients have asked me if they should go for Dutasteride [Avodart] since it is know with higher efficacy to Finasteride. I always reluctant to say that, Dutasteride is better because the side effects are also higher too.
How Dutasteride work?
Hereditary alopecia areata is the leading cause of hair loss in men worldwide. by a hormone called DHT or Dihydrotestosterone (dihydrotestosterone)
When genetically weakened hair follicles bind to DHT, they will react to make that hair follicle. There is deterioration and fall easily. Hair loss will gradually getting smaller and smaller until it becomes soft or vellus hair (Vellus hair)
Therefore, the most effective prevention and treatment today is DHT-resistant drugs.
Finasteride inhibits the activity of DHT by inhibiting the enzyme called 5Alpha reductase. Finasteride inhibits the activity of DHT by an average of 70%, so it is used to control hair loss. From genetics to expand into a wide area
Dutasteride, a newer DHT inhibitor, can reduce DHT activity by 90%. It can prevent hair loss and baldness better than Finasteride that has been using nowadays.
Does Dutasteride have more sexual diminish or more side effect than Finasteride?
Dutasteride inhibits DHT many times more than finasteride. Moreover, the duration of the drug in the blood stream is longer than Finasteride (Half life of Finasteride is 6-8 hours, while Dutasteride is approximately 4 weeks).
The elimination of the drug's residual effect from the body is therefore longer. This means that it takes more than 6 months for dutasteride levels to be cleared from your body after discontinuation of the drug.
Both of these issues make the side effects of dutasteride many times more than finasteride. Therefore, if those who used to administer drugs Finasteride has side effects such as decreased sexual performance Decreased sperm count, depression, and others associated with finasteride. It is assumed that if taking the drug Dutasteride is also likely to have more severe and long-lasting side effects than finasteride.
Who is Dutasteride suitable for?
Dutasteride is not considering as a first line treatment because of its serious side effects and slow breakdown of the drug in the body. Your doctor will consider using finasteride first. In case of one who has been using Finasteride for a while and still not effective in treatment or have used finasteride for a long time then developed drug resistance, the doctor will then ,consider prescribing dutasteride in the next order.
People who are suitable for Dutasteride should have used Finasteride in the past and not have too many side effects. People using dutasteride cannot donate blood. This is because the drug level in the blood takes a long time to dissolve completely. One must wait until 6 months before being able to go back and donate blood again.
The dose of dutasteride for the treatment of hereditary alopecia is 0.5 mg per day.
How good would it be if Dutasteride can be used to suppress hereditary hair loss without side effects?
Most of the dutasteride drugs currently available are taken orally. The topical form is going to be used in some foreign countries; however, the appropriate concentration is still not known. There are also some that are injected directly into the scalp and are starting to gain popularity.
Many researchers have found that Direct scalp injections were effective in reducing hereditary hair loss while there is no trace of drug or hormonal level change is detected. Presumably, it might be benefit to the treatment of genetic male alopecia who scared of the sexual side effects.
However, periodic intradermal injections were still needed. Studies on the optimal dose and administration of dutasteride are ongoing.
I am interesting in using more topical or injectable 5 alpha reductase inhibitors. Lately we have increasing evidence that topical 5AR can also give comparable result to the oral form. In that case , Dutasteride topical or Dutasteride injectable may play more roles.
Until now [February 2023] There are several regimens use in hair restoration doctor societies, for example;
- 0.5 mg Dutasteride once daily
- 1 mg Dutasteride once a week
- 1 mg Finasteride once daily + 0.5 mg Dutasteride once a week
- Topical Dutasteride
- Meso therapy of Dutasteride
In near future, we will have more conclusions about this and I will keep in touch.
References
1. Mesotherapy with Dutasteride in the Treatment of Androgenetic Alopecia
David Saceda-Corralo,1,2 Ana Rita Rodrigues-Barata,1,2 Sergio Vañó-Galván,1,2 and Pedro Jaén-Olasolo1,2
2. Dutasteride: A Review of Current Data on a Novel Dual Inhibitor of 5α Reductase, Sibylle Marihart, MD, Mike Harik, MD, and Bob Djavan, MD, PhD, Rev Urol. 2005 Fall; 7(4): 203–210.
23 February 2023
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