Minoxidil vs Dutasteride

Topical vasodilator (hair-growth stimulant)

5α-reductase inhibitor

An over-the-counter topical foam or solution (and an off-label low-dose oral tablet) that stimulates regrowth in pattern hair loss.

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

• Androgenetic alopecia — male and female pattern hair loss (topical Rogaine, available over the counter)
• Severe hypertension (oral minoxidil tablets, prescription)
• Low-dose oral minoxidil for hair loss is used off-label and is not FDA-approved for that purpose

• 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.

• Topical 5% foam or solution applied to the scalp once (women) or twice (men) daily
• Off-label oral minoxidil for hair loss: roughly 0.625–5 mg once daily under clinician supervision
• Oral minoxidil for hypertension: 5 mg daily to start, titrated up to 10–40 mg daily
• Regrowth takes about 3–6 months, and hair is lost again within months 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

• Scalp itching, dryness, or irritation (topical)
• Unwanted facial or body hair growth (hypertrichosis)
• A temporary increase in shedding when first starting
• Fluid retention and ankle swelling (oral)

• Rapid heartbeat or chest pain (oral)
• Pericardial effusion, occasionally progressing to tamponade (oral)
• Lightheadedness from a drop in blood pressure (oral)
• Contact dermatitis or severe scalp allergic reaction (topical)

• 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

• Adults with male or female pattern hair loss at the crown or hairline (topical)
• People seeking an off-label oral option when topical treatment is impractical or ineffective

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

• Known hypersensitivity to minoxidil
• Pheochromocytoma (oral)
• Topical use on a scalp that is broken, infected, or sunburned

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

• Topical minoxidil is only for androgenetic alopecia, not sudden or patchy hair loss
• Stop and seek care for chest pain, rapid heartbeat, dizziness, or sudden unexplained weight gain
• Oral minoxidil carries a boxed warning for serious cardiac and fluid effects and is prescribed with a beta-blocker and a diuretic
• Not for use in pregnancy or while breastfeeding without clinician guidance

• 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