Propecia vs. Avodart

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

Key Takeaways

  • Propecia (finasteride) is the only oral drug FDA-approved specifically for male pattern hair loss, while Avodart (dutasteride) is approved for an enlarged prostate and used off-label for hair loss.

  • Both drugs block the enzyme that shrinks hair follicles, but Avodart blocks two forms of that enzyme instead of one, which may make it more potent but also raises rates of sexual side effects in trials.

  • Propecia is a 1 mg tablet and Avodart a 0.5 mg capsule, both taken once daily, though Avodart's much longer half-life means its effects and side effects linger longer after stopping.

Propecia vs. Avodart Drug Summary

Propecia

Propecia is a 5-alpha-reductase inhibitor taken as a 1 mg tablet once a day. It is FDA-approved specifically to treat male pattern hair loss in adult men by lowering a hormone that shrinks scalp hair follicles. It has been used for this purpose since 1997.

Avodart

Avodart is also a 5-alpha-reductase inhibitor, taken as a 0.5 mg soft-gel capsule once a day. It is FDA-approved for symptoms of an enlarged prostate (BPH) and is commonly prescribed off-label for male pattern hair loss. It blocks two enzyme types instead of one, unlike Propecia.

Propecia vs. Avodart Side Effects

Propecia

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%)

Avodart

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

Propecia vs. Avodart Dosage

Propecia

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 1 mg once daily At the start
Maximum dose 1 mg once daily Same as starting
Dose changes None Fixed dose

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

Propecia vs. Avodart Indications

Propecia

Propecia is FDA-approved for one specific use: treating male pattern hair loss in adult men only. It works by lowering a hormone that shrinks hair follicles on the scalp over time. It is not approved for women or for use in children.

  • Treats androgenetic alopecia (male pattern hair loss) in men

  • Not approved for women or children

  • Slows further hair loss and can help regrow scalp hair

  • FDA-approved since 1997 specifically for this use

Avodart

Avodart is FDA-approved to treat symptoms of an enlarged prostate (BPH), not hair loss. Doctors sometimes prescribe it off-label for male pattern hair loss because it works similarly to Propecia. This hair loss use is common but has not been FDA-reviewed.

  • FDA-approved to treat enlarged prostate (BPH) symptoms

  • Reduces risk of urinary retention and BPH-related surgery

  • Used off-label for male pattern hair loss, not FDA-approved

  • Sometimes combined with tamsulosin for BPH treatment

Propecia vs. Avodart Pros and Cons

Propecia

Propecia has decades of safety data and is the only oral drug specifically FDA-approved for hair loss. It carries a lower overall rate of sexual side effects than Avodart in clinical trials, though rare cases of persistent symptoms have been reported.

Pros

  • FDA-approved specifically for male pattern hair loss

  • Lower rates of sexual side effects in clinical trials (1-2%)

  • Long track record of use since 1997

Cons

  • Not approved for treating an enlarged prostate

  • Post-finasteride syndrome has been reported after stopping

  • Only inhibits one of the two relevant enzyme types

  • Requires daily use indefinitely to maintain results

Avodart

Avodart's dual-enzyme action may make it more effective for hair regrowth in off-label studies, but it is not FDA-approved for this use, and its label reflects prostate-related data instead. Its long half-life means effects and side effects can linger for weeks after stopping.

Pros

  • Inhibits both enzyme types, which may boost hair-growth potency in studies

  • Also FDA-approved to treat an enlarged prostate (BPH)

  • Long half-life may allow flexible, less-frequent off-label dosing

Cons

  • Not FDA-approved for hair loss; use is off-label

  • Higher rates of sexual side effects in trials (5-7%)

  • Brand-name Avodart typically costs $1,600 to $1,900 per month

  • Side effects can linger for weeks after stopping due to long half-life

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