Dutasteride
Dutasteride is a medication for pattern hair loss. It is technically an antiandrogen, but it is not a testosterone blocker. It is very similar to finasteride, but slightly more powerful, and less widely used.
Pattern hair loss is caused mainly by dihydrotestosterone (DHT): a hormone that is produced in the body from testosterone, and is more masculinizing than testosterone itself. Where other antiandrogens block both DHT and testosterone, dutasteride (like finasteride) only selectively blocks the production of DHT, without blocking testosterone. Dutasteride blocks more DHT than finasteride does while having a similar rate of side effects (Evans & Goa, 2003; Zhou et al., 2019).
Like finasteride, dutasteride cannot be used to lower testosterone levels in transfeminine people, and in fact slightly increases them (Maeda et al., 2018).
Key points
- Like other antiandrogens, blocks DHT to prevent male pattern baldness
- Unlike other antiandrogens, does not block testosterone
- Comparable to finasteride, but blocks DHT more powerfully.
Dosing
Dutasteride is a pill that is swallowed. Trans people most commonly take it at a dose of 0.5 mg once daily, and it is rarely used at any other dose (Deutsch, 2016).
Risks & management
Because it works through the same mechanism as finasteride, dutasteride may have a very small risk of causing negative sexual, psychological, and neurological effects that persist even after stopping the drug. These are sometimes referred to as post-finasteride syndrome.
Interactions
Dutasteride has minimal interactions with other drugs (Evans & Goa, 2003).
Other information
Dutasteride is also called "Avodart", "Duprost", "Dutagen", "Dutaheal", "Dutanol", "Dutas", "Veltride", or simply "Dut"
See also
References
- Deutsch, M. B. (Ed.). (2016). Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People, 2nd Edition. San Francisco: University of California, San Francisco/UCSF Transgender Care. [URL(https://transcare.ucsf.edu/guidelines)] [PDF(https://transcare.ucsf.edu/sites/transcare.ucsf.edu/files/Transgender-PGACG-6-17-16.pdf)]
- Evans, H. C., & Goa, K. L. (2003). Dutasteride. Drugs & aging, 20(12), 905–918. [DOI:10.2165/00002512-200320120-00005]
- Maeda, T., Kikuchi, E., Hasegawa, M., Homma, K., Ando, T., Suzuki, K., Kaneko, G., Mizuno, R., Miyajima, A., & Oya, M. (2018). Influence of dutasteride treatment on serum hormone levels and aging male symptoms in patients with benign prostatic enlargement. International journal of urology : official journal of the Japanese Urological Association, 25(1), 70–74. [DOI:10.1111/iju.13470]
- Zhou, Z., Song, S., Gao, Z., Wu, J., Ma, J., & Cui, Y. (2019). The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis. Clinical interventions in aging, 14, 399–406. [DOI: 10.2147/CIA.S192435 ]