Dutasteride (Avodart) & Topical Dutasteride
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I want to talk about a topic that I actually have zero clinical experience on, but I’m just starting to prescribe. It is Topical Dutasteride. So, Dutasteride is the generic name for something called Avodart. And Avodart is an oral medication that blocks both type 1 and type 2 finasteride, or excuse me, type 1 or type 2 type 1 and type 2 Alpha reductase which means that it blocks close to a hundred percent of circulating dihydrotestosterone. And that means that there is less of a chance for progression of male pattern baldness. It doesn’t mean there is no chance but the side effects are higher and that is why I’ve steered away from prescribing oral Dutasteride or oral Avodart if at all possible. Now, there has been a formulation of topical dutasteride which again, I’m just starting to prescribe to patients. That is double the cost of topical finasteride, but promises to be potentially more powerful and stopping or slowing down, I should say, the male pattern hair loss. So in general, I don’t prescribe Avodart which is the oral version of Dutasteride. But I am starting to prescribe topical dutasteride. I’d so if you’re my patient and you’re advancing with topical finasteride, I may consider putting you on topical dutasteride. Just like any kind of alpha reductase inhibitor that is out there, like Propecia or finasteride I would not give it to a premenopausal female or and I would not give it to someone that is could we visit being exposed to a pregnant female that could ingest the topical ingredients. So this is actually more for my patients that are getting topical finasteride and maybe they’re still advancing especially for the young patients that want more aggressive treatment to try to slow down and reverse their current state of hair loss. I’m now exploring topical do tasks and will give you up. Updates over the next couple of years to see how this works. But to me it’s potentially promising as a therapy that minimizes potential side effects and offers an improved therapy for men in particular, who are seeking restoration of their hair loss. What’s interesting though of note is oral dutasteride, which is prescribed in various degrees. Again, I don’t like to prescribe it because of how strong it is, but some people prescribed it the 0.5 milligrams, once a day, some do it three times a week, some do it twice a week, so I will do it once a week and it really is something that there’s no clear consensus but the it has a much longer half-life than finasteride which is blocking only type 2 Alpha reductase and blocks about 69% of circulating DHT verses about 99% with dutasteride. What’s also interesting is that in other countries such as Korea and I can’t recall, it is one of the countries that actually has gone through full phase 3 clinical trials to manage hair loss, using dutasteride. And they’ve shown clinical efficacy through all three clinical phases, just in the United States. The company that makes Avodart decided not to spend the millions of dollars to try to go through FDA clearance for it as a therapy for hair loss and one other side. I think everyone knows that. It is FDA cleared for prostate. So therefore, it is perfectly legal for a doctor to prescribe it for hair loss. If you counsel you about the pros and cons limitations warnings, Etc. So it’s not illegal. So it is FDA cleared for use in the United States. It’s just not FDA cleared for use for hair loss and therefore, it is an off-label indication.