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Dutasteride - does it help against hair loss?

Dutasteride - does it help against hair loss?

Dutasteride (also known as Avodart and Avolve) is a drug used to treat enlarged prostate glands in men, a condition known as benign prostatic hyperplasia (BPH). It is also sometimes used for the treatment of male pattern baldness.

Dutasteride works by blocking the conversion of the male sex hormone testosterone to dihydrotestosterone (DHT). DHT is mainly formed in the prostate gland, testes, adrenal glands and hair follicles and is a cause of enlargement of the prostate and the miniaturisation of the hair follicle associated with hair loss in men. Dutasteride is not currently licensed and available in the UK for the treatment of hair loss.

Last reviewed: 16-04-2020 by Dr Simran Deo

Contents

Can it prevent hair loss?

Dutasteride is medically known as a dual 5-alpha-reductase inhibitor, which lowers DHT production to treat and improve the symptoms of BPH in men with an enlarged prostate. It has also been used to treat hair loss in men, and works in a similar way to finasteride (Propecia) to slow hair loss and regrow hair in men with male pattern baldness.

In men who are genetically prone to male pattern baldness, both dutasteride and finasteride stop DHT from binding to hair follicles. 

Dutasteride is only suitable for use by men over the age of 18, and must not be taken by women or children. It must not be handled by pregnant women, or women planning on becoming pregnant, as it can cause genital defects in male foetuses.

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Dutasteride and finasteride

Dutasteride works in a similar way to finasteride, the active ingredient in Propecia (finasteride) hair loss treatment. They are both oral tablets, taken daily, that work by inhibiting the 5-alpha-reductase enzyme that is responsible for converting testosterone to DHT. DHT is the hormone associated with male pattern hair loss and prostate gland enlargement. Dutasteride also inhibits an additional 5-alpha-reductase enzyme, which means in theory that it is a stronger treatment than finasteride. This also means that the side effects can be more severe too.

There have so far been no UK clinical trials conducted into the safety and effectiveness of dutasteride in the treatment of hair loss. It is approved in the US for the treatment of BPH, but isn’t currently approved in the US or the UK for the treatment of male pattern baldness. Dutasteride isn’t available for the treatment of hair loss, but you can buy Propecia which contains the active ingredient finasteride, which slows hair loss and promotes the growth of new hair. 

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Is dutasteride linked to prostate cancer?

In a clinical study of men at increased risk of prostate cancer, men taking dutasteride were shown to have a serious form of prostate cancer more often than men who weren’t taking the medicine. The study also showed that dutasteride reduced the incidence of prostate cancer for less serious tumours.

Dutasteride has been shown to affect the results of the PSA blood test which is used to detect prostate cancer. If you need to have this test, tell your doctor that you are taking dutasteride and they can take this effect into account when reading the results. 

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What are the side effects?

In common with all medications, dutasteride can cause side effects in some people. 

Common side effects (affecting 1 in 10 men):

 
Uncommon side effects (affecting 1 in 100 men):

  • heart failure - symptoms include shortness of breath, extreme fatigue and swelling in legs and ankles
  • hair loss or hair growth
Side effects where the frequency is not known:

  • feeling depressed
  • testicular swelling and pain

Dutasteride can cause an allergic reaction which can be serious if left untreated, so if you notice any of the following symptoms when taking the medication, stop taking it and get medical help straight away:

  • skin rash (sometimes itchy) 
  • hives 
  • swelling of the face, lips, tongue, eyelids, arms or legs
  • difficult breathing, chest tightness, shortness of breath

Certain medications also react with dutasteride and can make side effects more likely to occur. Tell your doctor before taking dutasteride if you are taking any of the following medications:

  • alpha-blockers (for enlarged prostate or high blood pressure). 
  • certain high blood pressure medicines 
  • HIV treatment
  • treatment for fungal infections 
  • certain antidepressants

Dutasteride is to be taken by men only and must not be taken by women, children or adolescents. Broken capsules must not be handled by pregnant women, as the active ingredient can be absorbed through the skin and can cause birth defects in male babies. If your partner is pregnant a condom must be used during sex. This is because dutasteride can be carried in semen and it could affect the normal development of a male baby. 

Dutasteride has been shown to reduce sperm count, semen volume and the movement of sperm, which could affect male fertility. Dutasteride is also not recommended for use by men with serious liver disease.

It can also cause male breast enlargement (gynaecomastia) and tenderness. You should see your doctor if this bothers you and if you notice lumps in the breast or discharge from your nipple. These could be signs of breast cancer.

If you are allergic to peanuts or soya, you mustn’t use dutasteride as it contains lecithin from soya, which could contain soya oil.

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