Combining Finasteride and Dutasteride for Male Balding.

Male AGA - Can finasteride and dutasteride be combinted

I’ve selected this question below for this week’s question of the week. It allows us to review the multitude of off label approaches for treating male balding.

Question

I am a male 25 years old. I am using finasteride 1 mg daily and have read some studies that dutasteride is even better. Can I combine the two such that one day I use finasteride and one day I used dutasteride. I would proposed to alternate back and forth like this.

Answer

Thanks for the question.

The could be an option for some males. Whether it’s a good option for you or not would need a pretty thorough review with the doctors that are overseeing your full care. Dutasteride and finasteride might not be good options for a variety of reasons including:

a) you have another diagnosis besides androgenetic hair loss for which antiandrogens might not be the appropriate treatment

b) you have moderate to severe depression as a medical condition

c) you do not wish to use these medications lifelong

d) you do not fully understand all the risks of 5 alpha reductase inhibitors and

e) you do not fully understand the alternatives available to you.

But mixing finasteride and dutasteride has been studied for over a decade. Of course, this is what we call an off label use. Even a dose of dutasteride on the weekends can often be an option for some men. An Australian study in 2013 reported a male who was initially treated with finasteride for androgenetic alopecia (male balding). Despite good compliance with the medication, the patient noted his hair density was not as good as previous years, and low-dose dutasteride at 0.5 mg once per week was added to the finasteride therapy. Interestingly, this treatment plan resulted in a dramatic increase in his hair density, demonstrating that combined therapy with finasteride and dutasteride can improve hair density in patients already taking finasteride.

Hair specialists who say finasteride and dutasteride do the same thing so why waste your time with thinking about this might not have reviewed all the published studies on finasteride and all the published studies on dutasteride. The reality is that 0.5 mg dutasteride taken daily is more effective than 1 mg finasteride taken daily. Now that does not mean everyone should take dutasteride. Not at all. But this is the data and the extrapolation would be that alternating finasteride and dutasteride would be more effective than finasteride daily. All males need to review side effects of finasteride and dutasteride in great depth with their prescriibing physician.

Thanks again for your question.

Reference

Boyapati A and Sinclair R. Combination therapy with finasteride and low-dose dutasteride in the treatment of androgenetic alopecia. Australasian J Dermatol 2013 -