If you’ve been using Finasteride for a while and aren’t seeing the results you hoped for, you might be thinking about shifting gears. Dutasteride could be a promising alternative – it works similarly to Finasteride, but early evidence suggests it could be more potent in some people.
Here’s what you need to know if you’re considering a switch.
What’s the difference between Finasteride and Dutasteride?
Finasteride and Dutasteride both block the enzyme 5-alpha reductase, which plays a key role in reducing levels of dihydrotestosterone (DHT) – the hormone responsible for male pattern baldness. While Finasteride inhibits type-I of the enzyme, Dutasteride inhibits both type-I and type-II, and is considered more potent than Finasteride – one study found 0.5mg Dutasteride daily reduced DHT levels by 93%, compared to 70% with Finasteride.
As they work so similarly, their side effect profiles are also similar. The most common category of side effects associated with both medications are sexual, such as decreased libido and erectile dysfunction. The half-life of Dutasteride is about 5 weeks, significantly longer than Finasteride which has a half-life of about 5 to 6 hours. This means Dutasteride remains in your system for longer, so side effects may persist longer after discontinuation.
A key difference between the two is that Finasteride is licensed by the MHRA for the treatment of androgenetic alopecia (AGA) in the UK, but Dutasteride is not. So, while extensive research has been done on Finasteride to establish how effective and safe it is for treating hair loss, the same standards have not been met for Dutasteride. However, it is available off-label, which means pharmacists and prescribers can use their judgement and clinical expertise to prescribe it for hair loss.
Why switch to Dutasteride from Finasteride?
Although Finasteride is clinically proven to be effective in preventing further hair loss in up to 90% of men, you might fall into the small percentage for whom it does not work. If that’s the case, you could consider Dutasteride. Early studies suggest Dutasteride may work better than Finasteride.
A 2017 study found results from Dutasteride 0.5mg superior to 1mg Finasteride over 24 weeks, with the group using Dutasteride seeing a greater increase in hair count and density.
If you have experienced side effects with Finasteride and this is the reason you’re thinking about a change, it doesn’t make sense to switch to Dutasteride as the associated side effects are similar.
Is topical Dutasteride better than oral?
If you're weighing up the pros and cons of topical versus oral Dutasteride, recent research offers some interesting insights.
One study tested three groups:
Group A: Minoxidil 5% twice daily
Group B: 5% Minoxidil + 0.5mg Dutasteride
Group C: Topical 0.02% Dutasteride + 4 microneedling sessions
Interestingly, Group C showed the best results, with fewer adverse events than Group B. However, this study has a few limitations: small sample size, short duration, and the baseline hair levels of participants were not standardized. That said, the study seems to suggest that topical Dutasteride is as or perhaps more effective than oral, with fewer side effects.
The risk of side effects with topical formulas is often lower because they are absorbed differently by the body. Whereas oral medications enter your bloodstream and work ‘systemically’, topical formulas work closer to where they are applied - aka the scalp - so not as much is absorbed into the blood. If you are worried about or have experienced side effects with oral Finasteride, topical versions may still bring similar benefits but reduce your risk of side effects.
How to switch from Dutasteride to Finasteride
If you're planning to switch from Finasteride to Dutasteride, it's important to stop taking Finasteride completely before starting Dutasteride. Since Finasteride has a short half-life (about 5-6 hours), you can usually begin Dutasteride a day or two after discontinuing it. We don’t recommend taking both medications at the same time, as there’s no research confirming the safety or effectiveness of combining them.
On the other hand, Minoxidil can safely be used alongside Dutasteride to help boost your results. Unlike Finasteride and Dutasteride, which work by blocking DHT, Minoxidil promotes blood flow to the scalp and extends the growth phase of hair follicles, making it a complementary treatment.
If you're unsure which treatment is best for you, you can take our free consultation for personalised recommendations.
All of our blog articles are reviewed by our Medical Director before publication.
