Dutasteride vs Finasteride: Which Is Better?

If you need hair loss treatment, then you’ve likely come across dutasteride and finasteride. 

They are a go-to medication solution for enlarged prostate. These drugs are 4-aza steroid competitive inhibitors of 5AR, the enzyme in charge of converting testosterone to DHT (dihydrotestosterone). 

They decrease DHT levels, and DHT is closely associated with male pattern hair loss. 

While both dutasteride and finasteride offer similar treatment benefits, they are very different in terms of efficiency and cost. 

Here, you can take a closer look at what distinguishes dutasteride vs finasteride, including some natural treatment alternatives you can go for. 

What Is Dutasteride? 

Dutasteride is a potent medication for managing benign prostatic hyperplasia. After 6 months of treatment, the drug curbs serum prostate-specific antigen levels by roughly 50%. While in 2 years, it decreases the total prostate volume by about 25%. 

Dutasteride can be prescribed alone or as a combination therapy alongside tamsulosin. It can thwart the signs of an enlargement of the prostate gland. 

This drug could decrease the patient’s odds of experiencing acute urinary retention, also known as being suddenly unable to urinate.

There is a possibility dutasteride can curb the odds of needing prostate surgery. The reason why dutasteride is so widely prescribed is that it leads to almost complete suppression of serum DHT – over 90%. Compared to finasteride, which can lead to 70%. 

Patients take the capsule by mouth and can expect their prostatic hyperplasia symptoms to subside in 3 months. However, it could take 6 months or more to use the product to its full potential. The medication is meant to curb the symptoms, not cure the ailment. 

dutasteride-side-effects

What Is Finasteride? 

Finasteride is a solid pharmacologic agent for managing prostatic hyperplasia symptoms and hair loss in men. This drug has also been used to treat the symptoms of extremely high testosterone levels in female patients. 

Long-term use for treating benign prostatic hyperplasia has been shown to reduce prostate volume. Therefore, it can relieve the troublesome urinary symptoms from the enlarged prostate gland.

Even if Finasteride can treat androgenic alopecia (hair loss in men), it won’t reduce DHT by 100%. It can slow hair loss, but it won’t stop it. 

This drug can be used alone or with doxazosin for the enlarged prostate. The goal is to manage the difficult or frequent urination and curb the odds of acute urinary retention. It could also reduce the odds of prostate surgery. 

When it comes to male hair loss, finasteride achieves the desired result by hindering the body’s DHT production on the scalp. 

The drug comes in the form of a tablet and is consumed by mouth. To treat the prostate gland symptoms, it can take a minimum of 6 months before patients notice a significant improvement. 

The results can show up in about 3 months or more for hair regrowth. It takes less time for it to work with the hair follicle and promote hair growth. That’s why patients shouldn’t expect a better hair count or improved male pattern hair loss overnight. 

finasteride-prostate-cancer

Similarities and Differences Between Dutasteride and Finasteride

These products have a lot in common. Both pharmacological agents are used for male pattern hair loss and benign prostatic hyperplasia treatment. 

They are both 5 alpha-reductase inhibitors. But, dutasteride is an inhibitor of type II and type I 5 alpha-reductase. Whereas finasteride is the inhibitor of solely the second type 5 alpha-reductase.

Patients with symptomatic BPH who take either finasteride or dutasteride can expect to have a reduction in the size of their prostate gland. 

Dutasteride is an FDA-approved drug, but just for treating BPH. While Finasteride is approved for both male pattern hair loss and BPH.

Dutasteride vs Finasteride Effectiveness 

Many studies have compared the efficacy of dutasteride vs finasteride. The primary difference is in their potency. 

Studies indicate that dutasteride treatment decreases serum DHT a lot more than finasteride. A 2019 report supports these claims. The study involved 576 participants, which helped compare the impact of both these medications. 

Based on the results, dutasteride had better efficacy in treating hair loss in men. It helped patients with male androgenetic alopecia achieve improved hair growth and hair count. The superiority of dutasteride over finasteride in hair regrowth was also shown in a 2017 report

Many studies indicate that finasteride decreases the risk of prostate cancer. Mainly in patients with frequent disease monitoring. 

Male patients who used the drug daily for a couple of years managed to drastically curb the odds of developing prostate cancer. But, these trials indicate that the drug could also increase the odds of high-grade prostate cancer.

Which Has Fewer Side Effects, Dutasteride or Finasteride?

When talking about dutasteride vs finasteride, it’s important to cover the side effects. Like any similar product on the market, these drugs can both cause sexual side effects. 

Possible dutasteride side effects include impotence, ejaculation disorders, and decreased libido. It can also cause exhaustion, dizziness, and headache. 

With finasteride, typical adverse events include loss of sex drive and erectile dysfunction. It can cause trouble maintaining or achieving an erection, problems with ejaculation, and pain in the testicles. Other adverse events can include a rash, hives, itchiness, swelling, and trouble swallowing or breathing.

According to experts, Finasteride caused fewer side effects that affect sexual health in men with benign prostatic hyperplasia. As a result, Finasteride is considered a more viable option for primary therapy. Based on clinical outcomes, the sexual side effects of the dutasteride group lead to a lot more withdrawals.

About 5.1% of men withdrew from the dutasteride group because of erectile dysfunction. Compared to 2.1% in the finasteride group for the exact same reason. 

Other adverse events that led to withdrawals from the dutasteride group included plummeting libido, ejaculatory dysfunction, and breast tenderness or enlarged breasts. 

Both medications are effective. But, because their side effect profile is different, finasteride could be a better alternative.

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Which Medication Is Cheaper?

Dutasteride seems to be a more cost-effective option for managing BPH symptoms than finasteride. To evaluate the differences in costs between the two, experts did a retrospective analysis of patients with an enlarged prostate. 

They recorded how much patients would spend a month on average. This included all the total charges like in-patient, outpatient treatment, physician care, medical care, etc.

Exactly 4,498 patients met the criteria. Those who took dutasteride spent $51 less a month on medical expenses than the finasteride group. 

This suggests that despite the higher cost of dutasteride, patients may be spending less on physician office visits, outpatient costs, and hospitalization costs. Another report showed similar results. Dutasteride was estimated as a more affordable product in the long run. 

Can I Take Dutasteride and Finasteride Together?

No. These drugs are meant to be taken separately. Dutasteride can be used alongside tamsulosin. 

Combination therapy offers a more drastic symptom improvement. Dutasteride is here to decrease the size of the prostate. In contrast, tamsulosin is meant to relax the muscles and help the bladder. This can aid with normal urine flow. 

Finasteride is typically combined with doxazosin. They can create more effective results when used together than when used alone. 

Doxazosin is an alpha-blocker capable of reducing smooth muscle tone in the bladder neck, and prostate. Finasteride is here to curb the prostate volume. 

One controlled trial showed that combination treatment with doxazosin and finasteride offered a better decrease in the risk of clinical progression of benign prostatic hyperplasia. They proved more effective than either drug alone in men with lower urinary tract symptoms.

prostate health supplements

Natural Alternatives to Dutasteride and Finasteride

The idea of using meds for hair loss can be off-putting for many people. That’s why countless individuals are turning to alternative, natural remedies that could help turn the tide. 

Do have in mind, however, that natural alternatives can’t replace conventional medication. They offer some benefits but may not have the exact same potency and effect. 

So, it is best to consult with a specialist first before adding any of these products to your diet. Here is a quick look at the natural alternatives to finasteride and dutasteride.

Saw Palmetto

Saw palmetto is a botanical extract with plenty of beneficial compounds. It has also become very popular for managing hair loss. 

Five clinical trials and multiple cohort studies showed a positive impact of both oral and topical saw palmetto supplements. 

Among those evaluated with androgenetic alopecia, there was a 60% improvement in overall hair quality, 83.3% in better hair density, and 27% in total hair count. Saw palmetto doesn’t cause any serious side effects, and it’s well-tolerated. 

This botanical extract is also quite effective in curbing BPH symptoms. It seems to be somewhat as potent as finasteride. But it is better tolerated and more tailored toward a tight budget. However, more research is necessary to study its long-term outcomes. 

saw palmetto benefits for men

Ecklonia Cava Extract

Ecklonia Cava is a type of brown algae packed with potent antioxidant properties. You can find it in the form of a supplement due to its potential medicinal compounds. 

Dieckol, the main component of Ecklonia Cava, can promote hair growth through the proliferation of dermal papilla cells. It can also inhibit the 5a reductase activity, making it a potential therapeutic compound for treating hair loss.

Pumpkin Seed Oil 

For men dealing with mild to moderate hair loss, a pumpkin seed oil supplement can help. It could create a positive anabolic effect. Thus stimulating more visible hair, increasing the hair size and hair follicles. This seed oil can also be an efficient and safe alternative treatment for BPH. 

Stinging Nettle Tea or Capsules

Despite the limited research, people use stinging nettle capsules or tea to combat hair loss. That’s because these leaves are packed with sulfur and silica, which are key components in minimizing hair thinning and breakage and regenerating the hair follicles. 

The plant also has beta-sitosterol, a chemical capable of raising growth factors that could promote hair growth. 

Today, many people are using the stinging nettle to alleviate urinary troubles in the early phase of BPH, including urinary tract infections, joint pain, and gout

But stinging nettle can’t reduce the size of the prostate. So, it is important to work with a healthcare specialist to pick a product that would work best for your prostate cells. 

prostatitis supplements stinging nettle

Green Tea

Many people who take either finasteride or dutasteride are worried about the sexual side effects that can come with them. After all, sexual dysfunction can be a real problem for men. 

Green tea might come in handy for keeping erectile dysfunction in check. It can boost blood flow, which, in turn, can be useful for your libido. 

Plus, the EGCG (epigallocatechin gallate) in this tea could prevent hair loss. It inhibits the activity of the hormone that causes the hair to fall out. Thus, offering better hair growth. 

Of course, it would take more than a single cup of tea to get the desired result. Especially when dealing with male pattern baldness and erectile dysfunction. 

But, more research is necessary to study the full extent of this tea and its impact on male pattern baldness. Overall, it can make for a practical natural approach for those eager to avoid the side effects of conventional medication. 

Conclusion

Finasteride and dutasteride are both prescription medications meant to treat BPH and hair loss. They are FDA-approved meds and capable of providing a solid benefit. 

Dutasteride has better efficacy than finasteride. It also seems to be cheaper in the long run. But, in terms of side effects, finasteride could be a better alternative. 

To amplify their results, these drugs can be used alongside other medicines. But, only a doctor can suggest which option is better tailored to your needs. 

Those who want to take a more natural approach may experience a practical benefit with other natural alternatives. These include saw palmetto, ecklonia cava extract, pumpkin seed oil, stinging nettle, and green tea.

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Sources

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