Finasteride vs Dutasteride: Which Is Right for You?
Dutasteride blocks more DHT than finasteride. It also has a longer half-life. Here is when each makes sense.
The mechanism difference
Finasteride inhibits 5-alpha reductase type II. Dutasteride inhibits both type I and type II. DHT suppression: ~60% with finasteride, ~90% with dutasteride.
What the trials show
Head-to-head trials show dutasteride produces more hair growth than finasteride. The effect size is real but not huge, most of the benefit is captured by finasteride for most men.
The half-life trade-off
Finasteride half-life: hours. Dutasteride half-life: weeks. If side effects develop, they take longer to resolve on dutasteride.
Who switches
Men with aggressive loss not stabilized by finasteride. Men whose hair pattern is dominated by type I reductase activity. A practitioner reads the picture.
Frequently asked questions
Can I start on dutasteride?
Most practitioners start with finasteride. If response is inadequate at 12 months, dutasteride is a reasonable second line.
Are side effects worse on dutasteride?
Slightly higher reported rates in some trials.
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