Hair loss
Avodart
dutasteride / pronounced [doo tas' ter ide]
Stronger DHT blocker than finasteride. Off-label for hair loss. Higher effect, smaller evidence base.
- Manufacturer
- GlaxoSmithKline (Avodart)
- FDA approved
- 2001
FDA-approved for
- Benign prostatic hyperplasia
Why is Avodart prescribed?
Dutasteride is FDA-approved for benign prostatic hyperplasia. Used off-label at 0.5mg daily for male-pattern hair loss. Blocks both isoforms of 5-alpha reductase (finasteride only blocks one), so DHT suppression is more complete (~90% vs ~70%).
FDA-approved indications:
- Benign prostatic hyperplasia
How does Avodart work?
Same pathway as finasteride, deeper suppression of DHT. Head-to-head trials show ~1.5x the hair-count increase of finasteride at 6 months.
Who qualifies for Avodart?
Adult men with male-pattern hair loss, typically after a finasteride trial. Same contraindications: not for women of childbearing potential. Some clinicians prefer to try finasteride first because of the smaller dutasteride evidence base.
How should Avodart be used?
0.5mg orally once daily.
What should I do if I forget a dose?
Dutasteride is dosed daily. If missed: skip and resume next day at regular time. Do not double up. Half-life is very long (~5 weeks), so a single missed dose has minimal clinical effect, but consistency matters for the dosing schedule.
What side effects can Avodart cause?
Similar profile to finasteride. Some studies show slightly higher rate of sexual side effects, others show no difference. Smaller long-term safety dataset than finasteride.
What interactions should clinicians watch for?
Dutasteride has a similar interaction profile to finasteride (both 5-alpha-reductase inhibitors). Reduces PSA by approximately 50% — flag to any prostate cancer screening. Caution with CYP3A4 inhibitors (ketoconazole, ritonavir — can elevate dutasteride blood levels). No major interactions with cardiovascular medications.
What special precautions should I follow?
Pregnancy & lactation
Strictly contraindicated in pregnancy — risk of feminization of male fetuses similar to finasteride. Avoid skin contact with capsule contents if pregnant. Dutasteride persists in semen for months after stopping; condoms are recommended during pregnancy planning with female partners.
Alcohol
No formal contraindication. Mood-related side effects (rare but reported) may be compounded by heavy alcohol. Moderate use is compatible.
What does Avodart cost?
$45-90/month via telehealth platforms that prescribe (Hims, Keeps offer it). Generic is available at standard pharmacies for similar pricing.
In case of emergency or overdose
No specific antidote for dutasteride overdose. The drug has a very long half-life (~5 weeks at steady state) — much longer than finasteride. Single doses up to 40 mg/day for 7 days were tolerated in trials without major adverse events. Call US Poison Control at 1-800-222-1222 if you suspect overdose; the long half-life means monitoring may be needed for weeks. Sexual side effects and depressed mood are the symptoms most likely to require attention with chronic over-exposure.
Primary sources
Related clinical resources
What clinicians say
Quotes from published interviews, peer-reviewed commentary, and conference presentations. Each is attributed and linked to the original source.
“Dutasteride 0.5 mg daily resulted in greater scalp hair growth than finasteride 1 mg daily at 24 weeks. The dual 5-alpha-reductase inhibition profile of dutasteride may translate into superior efficacy for androgenetic alopecia in selected patients, though approval for this indication varies by jurisdiction.”
Source: Journal of the American Academy of Dermatology — The Importance of Dual 5-Alpha-Reductase Inhibition in the Treatment of Male Pattern Hair Loss (December 2006 — PMID 17110217)
“Women who are or may potentially be pregnant must not handle Avodart capsules. Should a woman who is pregnant come into contact with leaking dutasteride capsules, the contact area should be washed immediately with soap and water. Dutasteride is absorbed through the skin and could potentially harm a male fetus.”
Source: FDA-approved Avodart (dutasteride) prescribing information — current label (Approved November 2001; current label 2014)