Finasteride vs. Avodart

See how Finasteride and Avodart compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Finasteride is FDA-approved for both male pattern hair loss and BPH, while Avodart is approved only for BPH and used off-label for hair loss.

  • Avodart blocks both type 1 and type 2 5-alpha-reductase enzymes, while finasteride blocks only type 2, which may give Avodart more complete DHT suppression.

  • Both drugs share warnings about sexual side effects, high-grade prostate cancer risk, lowered PSA readings, and fetal harm if handled or used by pregnant women.

Finasteride vs. Avodart Drug Summary

Finasteride

Finasteride is an oral 5-alpha-reductase inhibitor FDA-approved for male pattern hair loss at 1 mg and symptomatic BPH at 5 mg. It works by blocking the type 2 5-alpha-reductase enzyme to lower DHT and is taken once daily. It's also used off-label for hirsutism in women with excess androgen.

Avodart

Avodart (dutasteride) is an oral 5-alpha-reductase inhibitor FDA-approved for symptomatic BPH, taken once daily as a 0.5 mg capsule. It blocks both type 1 and type 2 5-alpha-reductase enzymes for more complete DHT suppression, and it's sometimes used off-label for male pattern hair loss.

Finasteride vs. Avodart Side Effects

Finasteride

Most common
decreased libido (up to 1.8%)
erectile dysfunction (up to 1.3%)
decreased ejaculate volume (up to 1.2%)
ejaculation disorder (up to 1.2%)

Avodart

Most common
impotence (up to 7%)
decreased libido (up to 5%)
breast disorders (up to 1%)
ejaculation disorders (up to 1%)

Finasteride vs. Avodart Dosage

Finasteride

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg once daily At the start
Maximum dose 5 mg once daily If needed
Dose changes 1 increase As tolerated

Avodart

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 0.5 mg once daily At the start
Maximum dose 0.5 mg once daily Same as starting
Dose changes None Fixed dose

Finasteride vs. Avodart Indications

Finasteride

Finasteride comes in two FDA-approved strengths: 1 mg for male pattern hair loss and 5 mg for symptomatic BPH. It lowers DHT by blocking the type 2 5-alpha-reductase enzyme, which shrinks hair follicles and enlarges the prostate. It's also used off-label for hirsutism in women with hyperandrogenism.

  • Male pattern hair loss (androgenetic alopecia), 1 mg dose

  • Symptomatic BPH in men with an enlarged prostate, 5 mg dose

  • Off-label: hirsutism in women with hyperandrogenism

Avodart

Avodart (dutasteride) is FDA-approved only for symptomatic BPH, including reducing the risk of acute urinary retention and the need for prostate surgery. It's also prescribed with tamsulosin for BPH, and it's used off-label for male pattern hair loss even though it isn't approved for that purpose.

  • Symptomatic BPH in men with an enlarged prostate

  • Reduces risk of acute urinary retention and BPH surgery

  • Combined with tamsulosin for symptomatic BPH

Finasteride vs. Avodart Pros and Cons

Finasteride

Finasteride has a long track record, lower reported rates of sexual side effects, and a much lower price than brand-name Avodart, though it blocks only one of the two DHT-producing enzymes. Insurance coverage for the 1 mg hair-loss dose is inconsistent since hair loss isn't considered medically necessary.

Pros

  • Only 5-alpha-reductase inhibitor FDA-approved specifically for male pattern hair loss

  • Lower reported rates of decreased libido and erectile dysfunction than dutasteride

  • Shorter half-life, so effects clear faster if the medication is stopped

  • Generic tablets are inexpensive, typically $10 to $50 a month, versus Avodart's $1,600 to $1,900 brand price

Cons

  • Blocks only the type 2 5-alpha-reductase enzyme, giving less complete DHT suppression than dutasteride's dual-enzyme action

  • Comes in two different-strength products (1 mg Propecia, 5 mg Proscar), so doses can be confused across indications

  • Not FDA-approved to reduce the risk of BPH-related surgery or urinary retention the way dutasteride is

Avodart

Avodart's dual-enzyme blockade may suppress DHT more completely than finasteride, and it carries added BPH-specific approvals like reducing surgery risk. It isn't FDA-approved for hair loss, has higher reported rates of sexual side effects, and its brand-name price is far above generic finasteride.

Pros

  • Blocks both type 1 and type 2 5-alpha-reductase enzymes for more complete DHT suppression

  • FDA-approved to reduce the risk of acute urinary retention and need for BPH surgery

  • Available as a combination pill with tamsulosin for BPH

  • Long half-life (~5 weeks) provides steady DHT suppression even after an occasional missed dose

Cons

  • Not FDA-approved for hair loss, so use for that purpose is off-label

  • Higher reported rates of erectile dysfunction (~7%) and decreased libido (~5%) than finasteride

  • Brand-name price runs $1,600 to $1,900 a month, far above generic finasteride's $10 to $50, though generic dutasteride is much cheaper

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