Vince
Super Moderator
Dutasteride is a dual 5α-reductase inhibitor for the treatment of benign prostatic hyperplasia. It differs from finasteride as it inhibits both isoenzymes of 5α-reductase and results in near-complete suppression of serum dihydro-testosterone.
Dutasteride: A Review of Current Data on a Novel Dual Inhibitor of 5α Reductase
Dutasteride: A Review of Current Data on a Novel Dual Inhibitor of 5α Reductase
madman
Super Moderator
Not only does Dutasteride have a stronger effect on suppressing DHT.....hence a lower dose is needed but it inhibits both Type 1 and 2 (5AR) as opposed to Finasteride which only inhibits Type 2 (5AR).
Comparison of Clinical Trials With Finasteride and Dutasteride (2004)
Abstract
Finasteride selectively inhibits the Type 2 isoenzyme of 5α-reductase (5AR) (the enzyme responsible for converting testosterone to dihydrotestosterone [DHT]) whereas dutasteride inhibits both Type 1 and Type 2 5AR. General conclusions regarding the differences and similarities of these 2 agents, in terms of pharmacologic effect, safety, and efficacy, can be drawn from the evaluation of short-term comparative trials and similar but non-comparative long-term trials. Dutasteride therapy reduces serum DHT significantly more than finasteride. In men with benign prostatic hyperplasia (BPH), treatment with either agent results in similar prostate gland volume reduction, flow rate, and symptom improvement, and similar reductions in long-term risk of BPH development in terms of symptom progression and acute urinary retention (AUR) and BPH-related surgery. There does not appear to be any clinically significant difference between the adverse event profiles of dutasteride and finasteride. Although weak evidence suggests a difference in the onset of clinical benefit, the available non-comparative trial data do not confirm this finding. Patients with symptomatic BPH who receive dutasteride or finasteride, either as monotherapy or combination therapy with α-blockers, can expect to experience significant prostate gland size reduction, improved symptoms, and reduced risk of progression in terms of long-term adverse outcomes.
Figure 1
The 2 5α-reductase inhibitors (5ARIs), dutasteride and finasteride, suppress dihydrotestosterone (DHT) by inhibiting the conversion of testosterone to DHT. Finasteride inhibits only the Type 2 5AR isoenzyme, whereas dutasteride, the only dual 5ARI, selectively inhibits both Type 1 and Type 2 5AR isoenzymes. Data from Bartsch G et al.1
Figure 2
A comparative phase II evaluation of dutasteride and finasteride in a double-blind placebo-controlled trial clearly demonstrates that serum dihydrotestosterone (DHT) suppression is significantly greater with dutasteride (0.5 mg daily) than with finasteride (5 mg daily). Data from Clark RV et al.3
Conclusion
Without evidence from long-term clinical trials comparing the safety and efficacy of dutasteride and finasteride, firm conclusions regarding the relative efficacy and safety of one agent over the other cannot be made. However, indirect comparisons of long-term changes in prostate volume and symptoms (Figures 5A and B) and general conclusions drawn from the evaluation of short-term comparative trials and similar but non-comparative long-term trials can be made (Table 4). One such conclusion is that dutasteride therapy reduces serum DHT significantly more than finasteride. In addition, treatment with either agent results in similar prostate gland volume reduction, flow rate, and symptom improvement, and similar reductions in long-term risk of BPH development in terms of symptom progression and AUR and BPH-related surgery. There does not appear to be any clinically significant difference between the adverse event profile of dutasteride and finasteride. Although weak evidence suggests a difference in the onset of clinical benefit, the available non-comparative trial data do not confirm this finding. Patients with symptomatic BPH who receive dutasteride or finasteride, either as monotherapy or combination therapy with α-blockers, can expect to experience significant prostate gland size reduction, improved symptoms, and reduced risk of progression in terms of long-term adverse outcomes.
madman
Super Moderator
The efficacy and safety of dutasteride compared with finasteride in treating men with androgenetic alopecia: a systematic review and meta-analysis (2019)
Aim: We performed a meta-analysis to evaluate the efficacy and safety of dutasteride and finasteride in treating men with androgenetic alopecia (AGA) during a 24-week treatment cycle.
Methods: Randomized controlled trials of dutasteride and finasteride for treating AGA were searched using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The data were calculated using Rev Man v5.3.0. The reference lists of retrieved studies were also investigated.
Results: Three articles including 576 participants which compared dutasteride with finasteride were selected for our analysis. The mean change in total hair count (mean difference [MD], 28.57; 95% CI, 18.75–38.39; P,0.00001), investigator’s assessment of global photographs for the vertex (MD, 0.68; 95% CI, 0.13–1.23; P=0.02) and frontal (MD, 0.63; 95% CI, 0.13–1.13; P=0.01) views, panel global photographic assessment for the vertex (MD, 0.17; 95% CI, 0.09–0.24; P,0.00001) and frontal (MD, 0.25; 95% CI, 0.18–0.31; P,0.00001) views, and subjects’ assessment (MD, 0.56; 95% CI, 0.18–0.94; P=0.003) suggested that dutasteride provided a better efficacy in treating men with AGA compared with finasteride. With regard to the assessment of safety, altered libido (P=0.54), erectile dysfunction (P=0.07), and ejaculation disorders (P=0.58), dutasteride did not show a significant difference compared with finasteride.
Conclusion: Dutasteride seems to provide a better efficacy compared with finasteride in treating AGA. The two drugs appear to show similar rates of adverse reactions, especially in sexual dysfunction.
Aim: We performed a meta-analysis to evaluate the efficacy and safety of dutasteride and finasteride in treating men with androgenetic alopecia (AGA) during a 24-week treatment cycle.
Methods: Randomized controlled trials of dutasteride and finasteride for treating AGA were searched using MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The data were calculated using Rev Man v5.3.0. The reference lists of retrieved studies were also investigated.
Results: Three articles including 576 participants which compared dutasteride with finasteride were selected for our analysis. The mean change in total hair count (mean difference [MD], 28.57; 95% CI, 18.75–38.39; P,0.00001), investigator’s assessment of global photographs for the vertex (MD, 0.68; 95% CI, 0.13–1.23; P=0.02) and frontal (MD, 0.63; 95% CI, 0.13–1.13; P=0.01) views, panel global photographic assessment for the vertex (MD, 0.17; 95% CI, 0.09–0.24; P,0.00001) and frontal (MD, 0.25; 95% CI, 0.18–0.31; P,0.00001) views, and subjects’ assessment (MD, 0.56; 95% CI, 0.18–0.94; P=0.003) suggested that dutasteride provided a better efficacy in treating men with AGA compared with finasteride. With regard to the assessment of safety, altered libido (P=0.54), erectile dysfunction (P=0.07), and ejaculation disorders (P=0.58), dutasteride did not show a significant difference compared with finasteride.
Conclusion: Dutasteride seems to provide a better efficacy compared with finasteride in treating AGA. The two drugs appear to show similar rates of adverse reactions, especially in sexual dysfunction.
DragonBits
Well-Known Member
I would probably go for Finasteride since it is already used in Propecia and it's a less drastic reduction in DHT but similar shrinkage in prostate volume.
Though I believe that unless you eliminate the reason for your prostate growth, once you stop Finasteride your prostate will just grow back.
BTW, LEF ultra prostate formula also appeared to reduce my DHT from 74 ng/dl >43 with less risk. I stopped the supplement and will have to see if my PSA goes back up, I don't really know if my prostate shrank.
Though I believe that unless you eliminate the reason for your prostate growth, once you stop Finasteride your prostate will just grow back.
BTW, LEF ultra prostate formula also appeared to reduce my DHT from 74 ng/dl >43 with less risk. I stopped the supplement and will have to see if my PSA goes back up, I don't really know if my prostate shrank.
Vince
Super Moderator
DragonBits, how high was your PSA level.
DragonBits
Well-Known Member
In 6 months my PSA went from 2.4>4.2, I stopped HCG/DHEA continued with TRT and with supplements my PSA went back down to 3.4. After that I stopped the LEF prostate supplement. I also take turmeric and continue to do so.
A month ago I then restarted DHEA/Preg and just friday took another PSA test, up down or stable I Have no idea.
Vince
Super Moderator
You're really doing your homework. Hopefully your PSA will stay in a decent range.
First post or question on this forum so forgive the lack of knowledge or asking things that have been covered on other posts.
Been on low dose T for approx 3 yrs 30-40c...usually once a week...sometimes twice if at home and hitting gym regular.
Original protocol prescribed T 40c twice a wk...HCG 50c...preg...
T was 265 at start....went up to mid 700 all felt great.
Problem....I have long hair w no balding in family..after 1yr notice hair thinning a lot. Do lazer and Minoxidil for last 2yr...cut down to only T at low dose...no HCG...no Al...no preg...all feels good
Finally to question and this may be wrong forum so just direct me...
if I added Finasteride...does it help to the extent of regrowing any hair .or are the possible libido side effects not worth it...
This is directed to the guys that actually use this...
Thanks
Vince Carter
Banned
I'm quite surprised it took 10 posts before use of these things which chemically castrate a male was discouraged.
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