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Dutasteride

Chemical Name: Dutasteride
Drug Class: 5alpha-Reductase Inhibitor

Dutasteride is the second generation of 5alpha-Reductase inhibitors. The first in the class was Finasteride, which is the same chemical found in Proscar (5mgs/tab) and Propecia (1mg/tab). The important difference between Finasteride and Dutasteride is that Finasteride only acts on one of the 5a-reductase enzymes, while Dutasteride works on both (hence the name Du-tasteride, which is derived from “Dual-tasteride”.

Proscar was the first product of this type on the market, and was designed to protect men against the interactions of 5a-R and DHT on the prostate. At some point, it was discovered that this type of product would also help protect men from Androgenetic alopecia (AGA), or male-pattern baldness. This is the most common form of hair loss experienced by men, and it’s pathogenesis is thought to be primarily androgen dependent, however, genetic predisposition is the major requirement for this problem. Furthermore, X-chromosome (your mother’s genes) is the prime determinant of this problem (1). If the men in your mother’s family aren’t bald, then this won’t be much of an issue for you either. Possible prostate issues will still be a problem, and Dutasteride will help with those as well, with a bit more efficacy than you would see with Finasteride, due to it’s (2) ability to act on both enzymes which affect the prostate.

Unfortunately, low levels of 5a-Reductase and the resultant low levels of DHT, have been linked to gynocomastia, in some cases (3). I wouldn’t recommend staying on any 5a-R inhibitor for longer than necessary, in most cases. Of course, something to eliminate estrogen, such as Letrozole, may be used in order to combat possible side effects, but then you’re really getting on a slippery slope where you begin to use one drug to fight a side effect of another, and then a third drug to combat side effects from the second.

My advice is to use Dutasteride when you need to, but not all the time.

Reference:

1. Am J Hum Genet. 2005 Jul;77(1):140-8. Epub 2005 May 18

2. Pharmacologic Basis for the Enhanced Efficacy of Dutasteride against Prostatic Cancers.

3. Clin Cancer Res. 2006 Jul 1;12(13):4072-9.

Dutasteride. Drugs Aging. 2003;20(12):905-16; discussion 917-8. Review.

 
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