Firstly I would like to thank you for making an excllent website which has enabled me to educate myself while challenging you to answer questions which you have done.
If Dutasteride was approved by the FDA in 0.5mg daily, would you prescribe it to your patients instead of Propecia or do you consider propecia a good fight against hairloss?
If I prescribe an ‘off label’ drug, I am open to liability from state licensing boards and possibly medical-legal liability if something goes wrong (like the Vioxx problem). If dutasteride was approved to treat hair loss and thus would not need to be prescribed ‘off label’, then yes, I would consider prescribing it, provided that the risk factors were fully understood by me and the patient. For example, is there a substantial risk for sexual dysfunction with dutasteride that is higher than finasteride? The patient must know that risk (as I must know it), but right now the studies are not available. Without FDA approval, we really do not know what the effective dose of the medication is. The reality today is that the doctors are all guessing at the dose (not a good scenario) and the guess work is not based upon science.