Finasteride vs Dutasteride

5α-reductase inhibitor

5α-reductase inhibitor

A once-daily 1 mg oral tablet (Propecia) that blocks DHT to slow hair loss and regrow hair in men with male pattern baldness.

A 5α-reductase inhibitor FDA-approved for an enlarged prostate and used off-label at 0.5 mg daily for male pattern hair loss.

Hair loss (androgenetic alopecia)

Hair loss (off-label) / enlarged prostate

• Male pattern hair loss (androgenetic alopecia) in men, using finasteride 1 mg (Propecia)
• Benign prostatic hyperplasia, using finasteride 5 mg (Proscar)

• Symptomatic benign prostatic hyperplasia (BPH) to improve symptoms and reduce the risk of retention and surgery
• BPH in combination with tamsulosin
• Male pattern hair loss is an off-label use and is not FDA-approved for hair loss in the U.S.

• Hair loss: 1 mg by mouth once daily
• Three or more months of daily use is generally needed before benefit is seen
• Benefit is gradually lost within about a year of stopping

• BPH: 0.5 mg by mouth once daily, swallowed whole
• Off-label hair loss: 0.5 mg once daily under clinician supervision
• Dutasteride has a long half-life and stays in the body for weeks after the last dose

• Decreased libido
• Erectile dysfunction
• Decreased volume of ejaculate
• Ejaculation disorder

• Depression and, rarely, suicidal thoughts
• Male breast cancer (rare)
• Sexual side effects that persist after stopping in some men
• Allergic reactions including swelling of the lips or face

• Erectile dysfunction
• Decreased libido
• Ejaculation disorders
• Breast tenderness or enlargement (gynecomastia)

• Sexual side effects that persist after stopping in some men
• Serious allergic reactions including angioedema
• Depressed mood
• A possible increase in the risk of high-grade prostate cancer

• Adult men with mild to moderate male pattern hair loss at the vertex and mid-scalp
• Men who prefer an oral tablet over topical treatment

• Men seeking a stronger DHT blockade than finasteride, accepting off-label use for hair loss
• Men who did not respond adequately to finasteride

• Women who are or may become pregnant
• Children
• Known hypersensitivity to finasteride

• Women who are or may become pregnant
• Children
• Known serious hypersensitivity to dutasteride or other 5α-reductase inhibitors

• Women should not handle crushed or broken PROPECIA tablets when they are pregnant or may potentially be pregnant because of the possibility of absorption of finasteride and the subsequent potential risk to a male fetus
• PROPECIA causes a decrease in serum PSA levels; any confirmed increase in PSA while on PROPECIA may signal the presence of prostate cancer and should be evaluated, even if those values are still within the normal range for men not taking a 5α-reductase inhibitor
• 5α-reductase inhibitors may increase the risk of high-grade prostate cancer
• Mood changes including depression have been reported; stop and seek care if they occur

• Women who are pregnant or may be pregnant should not handle AVODART capsules due to potential risk to a male fetus, because dutasteride can be absorbed through the skin
• AVODART reduces serum prostate-specific antigen (PSA) concentration by approximately 50%; any confirmed increase in PSA while on AVODART may signal the presence of prostate cancer and should be evaluated, even if those values are still within the normal range for untreated men
• AVODART may increase the risk of high-grade prostate cancer
• Men should not donate blood until at least 6 months after their last dose to avoid exposing a pregnant recipient