Switching From Finasteride to Dutasteride for Hair Loss

Key Takeaways:

• Switching from finasteride to dutasteride may help if you’re not seeing enough improvement in hair loss.

• Dutasteride isn’t FDA-approved for hair loss, but it blocks more DHT than finasteride and may be more effective for some people.

• Follow your provider’s guidance on how and when to switch medications.

• Shedding while switching from finasteride to dutasteride is uncommon.

• Other treatments like minoxidil or saw palmetto can help boost results.
  

If you’re thinking of switching from finasteride to dutasteride for hair loss, there are some critical things to know.

Only two medications are approved by the Food and Drug Administration (FDA) specifically for hair loss: finasteride and minoxidil. There’s a ton of research backing their efficacy in slowing hair loss and even spurring regrowth, but these treatments may not yield results for everyone. If that’s you, your provider might prescribe an off-label medication, like dutasteride.

We’ll answer all your questions about switching from finasteride to dutasteride and go over alternative (and supplemental) hair loss treatment options to consider.

Before we dive into the differences between finasteride and dutasteride, let’s start with some similarities.

Finasteride and dutasteride are both FDA-approved for the treatment of an enlarged prostate (benign prostate hyperplasia or BPH).

If left untreated, BPH can lead to bladder, urinary, or kidney problems. Providers sometimes prescribe Proscar^® (finasteride) or Avodart^® (dutasteride) to treat BPH.

Finasteride and Dutasteride Are DHT Blockers for Hair Loss

Finasteride and Dutasteride are both 5-alpha reductase inhibitors (5ARIs). 5-alpha reductase (5AR) is an enzyme that converts testosterone into dihydrotestosterone (DHT), the hormone partially responsible for male pattern baldness (androgenetic alopecia).

You may have also heard these medications described as DHT blockers.

Essentially, high DHT levels cause hair to thin and shed for those genetically sensitive to it.

DHT-blocking medications are basically bouncers for your hair, keeping sketchy DHT out. They work by slowing or stopping the conversion of testosterone to DHT and reducing androgen receptors in hair follicles, thereby lowering DHT levels. That’s good news for your hair.

→ Learn more: Understanding 5-Alpha Reductase Inhibitors

Finasteride and dutasteride work very similarly, but there are some key differences:

• Type I vs. type II inhibitor. Finasteride is a type II 5AR inhibitor, and dutasteride is both a type I and a type II inhibitor. Type I of the enzyme is produced primarily in the liver and skin but makes its way to the prostate via blood circulation. Type II is the major form found in the prostate.

• FDA approval. As noted, finasteride is FDA-approved for male pattern hair loss. Dutasteride isn’t specifically approved for hair loss.

• Speed vs. effectiveness. Finasteride starts working more quickly. But dutasteride treatment generally shrinks the prostate more.

• DHT reduction. Finasteride reduces serum DHT by about 70 percent and prostate DHT by 80 to 90 percent. Dutasteride reduces serum DHT by as much as 99 percent. The latter might also have better results for hair loss.

While both finasteride and dutasteride are well-studied for BPH, we have a lot more information on finasteride for hair loss specifically.

Finasteride is considered the gold standard for genetic hair loss. For most men, it works well, and there’s no need to switch.

In a 10-year study on men taking finasteride for androgenetic alopecia, 99 percent experienced no worsening of hair loss during treatment, and 91 percent saw improvements in hair growth.

Having said that, not every single man will get results from this medication.

Finasteride Doesn’t Work for Everyone

Maybe you’re among the 9 percent of men who don’t see improvements in hair growth. In some cases, your healthcare provider or dermatologist may suggest switching to dutasteride.

Some studies suggest dutasteride works better than finasteride. We need more long-term data on finasteride vs. dutasteride for hair loss management. But short-term studies do suggest that dutasteride is more effective at increasing hair count and thickness.

What the Research Says About Dutasteride vs. Finasteride

A 2017 study compared the efficacy, safety, and tolerability of dutasteride and finasteride. It found that those who used dutasteride had a higher hair count and fewer thinning hairs than the finasteride group.

However, this study had a few flaws, so it shouldn’t be seen as the be-all and end-all. For instance, there was a small sample size of only 90 men, and the study period was only 6 months. Also, it was “open-label,” meaning the researchers and subjects knew what medication they were taking, which can cause confirmation bias.

A 2013 study also found that hair count and width increased with dutasteride, and the higher the dose, the greater the effects on hair. The dutasteride effects were more significant than finasteride or a placebo. This study had more than 900 people, but it was still short at only 24 weeks.

Any time you switch medications, it’s vital to let a healthcare provider know so they can guide you through the process.

But this is how it might go:

• You’ll need to fully stop taking oral finasteride before switching to dutasteride.

• Your provider will give you exact guidelines, but typically, finasteride leaves the body quickly (that’s why it’s important to take it every day to maintain results).

• Finasteride has a much shorter half-life than dutasteride, so you might be able to start taking dutasteride as soon as a day or 2 after your last dose of finasteride.

Generally speaking, finasteride and dutasteride shouldn’t be used together.

It’s possible your healthcare provider will approve the use of topical finasteride and oral dutasteride together. But we just don’t have enough research to know how the two interact.

If your goal is to keep your hair — we’ll go out on a limb and say it probably is — it’s understandable that any shake-up in your routine could make you worry about shedding and further hair loss.

Dutasteride shedding is possible but not super likely.

As you know, high levels of DHT shrink the hair follicle (miniaturization) and mess with the hair growth cycle. When there’s less DHT, hair follicles begin to work again. But before the healthy new hair growth cycle starts back up, the hair follicles need to shed the thinning or damaged hair.

This can lead to shedding.

Switching from finasteride to dutasteride probably wouldn’t be enough of a change to cause shedding — you’re more likely to see initial dutasteride or finasteride shedding when starting one of these medications for the first time. But it’s possible.

Dutasteride shedding is temporary. But again, it’s unlikely that making the switch from finasteride to dutasteride would actually cause this, especially if you start dutasteride within a few days of stopping finasteride.

The other thing that could potentially cause shedding when switching from finasteride to dutasteride is less about dutasteride itself and more about any other hair loss medications you may be stopping.

For example, if you’ve been using a combination of minoxidil and finasteride (more on that duo soon) and go cold turkey on both, you may see some shedding once minoxidil is out of your system. This is because minoxidil works differently from finasteride and dutasteride, so removing it can trigger shedding.

Finasteride and dutasteride have similar rates of adverse reactions, including sexual dysfunction issues. If anything, the side effects of dutasteride may be even more pronounced because it’s more potent.

Potential side effects of finasteride and dutasteride are usually mild and improve over time. They include:

• Low sex drive (libido)

• Reduced ejaculatory volume or other problems with ejaculation

• Sexual or erectile dysfunction (ED)

• Headache

• Gastrointestinal side effects (like nausea or constipation)

• Acne

• Dizziness

Since the adverse effects are so similar, it may not be worth switching from finasteride to dutasteride because you’re experiencing side effects. But your provider can help you make this decision.

Also, the pills shouldn’t be taken or handled by pregnant people due to their potential to cause birth defects (congenital abnormalities) in male fetuses.

As mentioned, finasteride and minoxidil are the only two FDA-approved treatments for hair loss.

If you’re considering switching from finasteride to dutasteride to boost results, adding minoxidil can also help. But it’s not the only other option.

Minoxidil

Topical minoxidil sends blood flow and nutrients to the scalp to support hair health. It alters the hair growth cycle by shortening the resting (telogen) phase and prolonging the growth (anagen) phase, resulting in increased hair length and thickness.

Topical minoxidil is over-the-counter (OTC), but oral minoxidil requires a prescription.

We offer topical minoxidil foam and minoxidil liquid solution, each containing 5% minoxidil.

Some prefer the foam because it doesn’t contain propylene glycol (an alcohol), which might cause redness or irritation in rare cases.

Prefer oral minoxidil? Following an online consultation with a healthcare professional, Hims offers a minoxidil chew formulated with other hair-healthy ingredients like biotin and vitamins B5 and B6.

Minoxidil and Finasteride Together

Minoxidil and finasteride are among the most effective combinations for fighting hair loss. A 2019 meta-analysis found that combining oral finasteride and topical minoxidil “has better therapeutic efficacy than and similar safety” to using just one or the other.

If you decide to double up on minoxidil and finasteride, we have two options:

• Our topical finasteride & minoxidil spray is our bestselling treatment. It combines the two ingredients in an easy-to-use spray.

• If you’d rather use an oral supplement, our minoxidil & finasteride chews combine the two with other hair health supplements.

Saw Palmetto Shampoo

You can’t use finasteride and dutasteride together, but you can amp up the effects of finasteride by adding saw palmetto to your routine.

Saw palmetto isn’t as well-researched as its FDA-approved counterparts, but it’s a partial DHT blocker.

Our thickening shampoo with saw palmetto is a good place to start.

It’s unlikely that a dermatologist or other healthcare provider will suggest an off-label hair loss treatment like dutasteride as a first line of defense, especially since the FDA-approved treatments are generally very effective. But certain situations may warrant transitioning from finasteride to dutasteride.

If you’re considering it, here are a few things to remember:

• Finasteride and dutasteride are both FDA-approved to treat an enlarged prostate, but only finasteride has approval for hair loss. 

• Most men see no further hair loss on finasteride, and some experience new hair regrowth. But studies comparing finasteride and dutasteride show that dutasteride increases hair thickness and slows further deterioration even more than finasteride.

• The two have similar side effects and aren’t meant to be used together.

• Always speak to your provider before switching medications. They can make suggestions and guide you through the process.

We offer a range of hair loss medications. Following a quick virtual consultation, a licensed healthcare provider can determine if a prescription is appropriate for your needs.

See answers to frequently asked questions about switching from finasteride to dutasteride.

Why switch from finasteride to dutasteride?

Some people switch from finasteride to dutasteride for hair loss if finasteride isn’t giving enough improvement. Dutasteride is able to block more DHT, which may boost hair thickness and regrowth.

Is dutasteride FDA-approved for hair loss?

No, dutasteride isn’t FDA-approved for hair loss. It’s approved to treat benign prostate hyperplasia, but research shows this medication can help increase hair count when used off-label.

How do you switch from finasteride to dutasteride?

Finasteride leaves the body quickly, so most people can transition from finasteride to dutasteride within a day or 2 of stopping finasteride. Always follow your provider’s guidance for exact timing.

Will switching from finasteride to dutasteride cause shedding?

Shedding during the switch from finasteride to dutasteride is uncommon and usually temporary if it happens. Sometimes, shedding is caused by stopping other treatments like minoxidil, not the dutasteride itself.

→ Read next: Finasteride Shedding: What It Is and How Long It Lasts

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards.