FINASTERIDE AND DUTASTERIDE
Finasteride and dutasteride are drugs used for the treatment of different kinds of alopecia on both males and females. They are drugs with a great effectiveness and an excellent safety profile, with a very low risk of side effects. However, there is the unjustified belief that these drugs are not safe.
The purpose of this document is summarizing current scientific evidence about these drugs.
Action Mecansims
Finasteride and dutasteride are selective antiandrogens of the follicle root, meaning that they exercise their action directly on the hair root, without affecting any other organs. They inhibit an enzyme called 5-alfa reductase (structure only present on the follicle root and the prostate), inhibiting the action of male hormones (androgens) on the follicle root. Dutasteride inhibits this structure in a more powerful and lasting way, that’s why it is more effective.
Both drugs started to be used and were launched to the market over 20 years ago for the treatment of benign prostatic hyperplasia on elder male patients, whose were observed an important improvement on hair density, that lead to the relevant effectiveness and safety research on male and female alopecia. Many of the false myths about these drugs come from their prospectus interpretation mistakes when they were used at higher doses in elder male patients.
Possible side effects
Any medication can have side effects. However, finasteride and dutasteride have a very low risk of side effects (less than 3%), and on research with thousands of patients we can observe that this risk is very similar to the one of the general population that doesn’t take any medication.
One of the side effects that was usually observed on male elders who were taking this medication was a decreased libido or transient erectile dysfunction. We must take into consideration that the doses they need are higher, and that their higher age predisposes to sexual nature issues. However, these drugs rarely produce this effect at the dose used for the treatment of alopecia, especially if we consider that patients who receive this medication are usually younger than male with prostate issues.
The side effects that could be observed in less than 3% of patients, and that anyhow will be transient, are:
- Decreased libido.
- Erectile dysfunction.
- Increased breast volume.
FAQ ABOUT THE TREATMENT WITH THESE DRUGS
If a male takes finasteride or dutasteride for his alopecia, what effect has on his prostate?
At the dose normally used for treating alopecia it won’t have any effects on the prostate. In any case, the effect will be positive, since it will prevent the prostate abnormally growing.
Can women take this medication despite it appears in the prospectus as a drug for men?
They can take it, always under medical prescription. The use of a drug out of the indication it was made for can be carried out, as long as there is scientific evidence of its effectiveness and safety. In the case of finasteride and dutasteride, there are many studies endorsing its effectiveness and safety for both male and female alopecia.
What care should a woman who’s taking finasteride or dutasteride take?
The most important one: she must avoid pregnancy while she is on this drug and some time after quitting it (1 month in the case of finasteride and 6 months in case of dutasteride).
Having taken these drugs however doesn’t impact negatively for a future pregnancy
Can I take finasteride or dutasteride if I am a man and I’m actively looking to have a baby?
This drug can be transmitted through sexual intercourse, so if you’re looking to become a father you must discontinue the treatment for a few months. I will tell you how to proceed, since the “washing” months may vary depending on the dose and the drug (dutasteride or finasteride) you take.
Do these drugs increase the risk of cancer?
These drugs don’t increase the risk of any type of cancer. There are many studies proving this fact
Is it necessary to carry out analytic checks or avoiding any kind of medication while taking these drugs?
Since they are selective medication on the follicle root, they are very safe drugs and there is no need for any analytic control, nor do they interact with other medication. Follow the instruction I gave you in your particular case. I normally like to carry out a blood test before starting any pharmacological treatment.
Commercial compound or magistral formula?
The use of finasteride for alopecia is currently indicated for androgenetic alopecia at a 1mg per day dose.
The use of dutasteride for alopecia is a “use out of its indication” nowadays. This means that there is no drug commercialized with dutasteride for patients with alopecia. We usually prescribe Avidart but the indication in the prospectus is for benign prostatic hyperplasia.
I generally turn to pharmaceutical compounds (meaning that the capsules are “manufactured” at the pharmacy with the prescribed dose for each patient). To avoid mistakes in the pharmaceutical compound, this must be made in specialized pharmacies with experience in formulating medication.
Are these drugs subsidized by Spanish Social Security?
No, they are not. They are subsidized only for prostatic hyperplasia in elder male.
What happens if I stop taking finasteride/dutasteride?
As the rest of the treatments for alopecia, these drugs are not curative and their positive effect will be maintained as long as the patients keep up with the treatment in time. For this reason, it is key that the treatment strategy is comfortable enough so that therapeutic adherence is good. The treatment being maintained continuously doesn’t mean that it must be taken daily, in fact, many patients keep up with a twice or three times a week therapy when alopecia is stabilized.
Do I need to take pills my whole life or is there other alternatives?
Pharmacological treatment is vital to stabilize alopecia, but as the patient gets older, doses can be lower and even lower and even discontinued in certain periods.
There is also the possibility of replacing the oral treatment with topic. Topic treatment is also quite effective if the patient is constant on its application.
Does finastopic work?
Topic solutions such as finastopic are an alternative to oral treatment as effective, as long as the patient is constant on its use and it is applied with the frequency indicated.