Month: January 2023

My MD has me on Avodart 0.5 MG once daily for hair loss and I have been taking it for about 20 months now and it seems to work better than the Proscar that I was taking the five years before.I just had my second HTP a couple of months ago and the HT doctor said the Avodart that I’m taking stays in my system fot 5-7 days and that I should not need to take it daily to have the same results. Where do you stand on it?

Avodart (dutasteride) does stay in your system for several weeks (5 weeks are reported for half of the drug to disappear from your system). In other words, if you take Avodart today only, half of the drug will be in your body in 5 weeks. In fact, the drug will still be detectable in your body for up to 6-12 months.

I do not personally recommend Avodart to my patients, because it is not proven safe for treating hair loss in younger men (the drug is a prostate medication, so the FDA approvals were based on tests of those men in an older age group). There are reports of sterility with this drug on men. I do have a handful of patients that choose to take Avodart despite my concerns, but that is on an individual basis. Likewise, my feeling on it is that you need to address these concerns with your doctor and decide on the appropriate treatment plan after understanding all the risks and benefits associated with its use. That stands true for all other drugs and medical treatments.

In general (to confuse the situation even further), the 0.5mg dose of Avodart is not generally used for hair growth, as 2.5mg is shown to produce a better effect. However, the 2.5mg will increase the side effects and the risks associated with it as well. All that is just more to discuss with your doctor. Read this study published in the Journal of the American Academy of Dermatology for more info — Dutasteride vs. Finasteride.

Dr. Rassman:

Prior to reading this, thank you for your time. Your insight and knowledge is of great appreciation.

My situation is as follows:

I started propecia, was on it for a month, then underwent a HT of 1,900 grafts mainly in the front hairline. I continued to use propecia for 2 more months and began to experience some serious sexual side effects. I stuck it out for another 3 weeks however the side effects continued so I stopped the propecia. The sad part is that the propecia began to halt my hairloss however I could not deal with the sexual side effects.

Sadly my hair is shedding. After another apt with my hair restoration doctor, he suggested I take Avodart 0.5mg twice/week. He had mentioned that some of his patients who were having side effects from Propecia took the Avodart bi-weekly, (due to the drugs long half life) and were able to halt hairloss but did not experience the side effects which I was experiencing from my daily 1mg Propecia regiment. I have read all of your posts in regards to Avodart and I understand that it is not FDA approved nor do you prescribe it to your patients.

My main question to you and issue at hand:

I know that when people start taking Avodart they experience a shedding phase which generally kicks in after the first month or two of starting the drug and can last a few months there after. My first question – If I am only taking the drug twice a week and have only been off of propecia for 4 weeks will I also experience a shedding phase? I am confident that the shedding phase is the transition to a greater good…as the weaker hairs fall out months later they are replaced by stronger, new hairs. My problem is that I am in the entertainment industry and will be starting a one month taping of a TV series from June 30th-July 30th. I would like to have as much hair as possible by that time so would I be better off waiting to take the Avodart after the taping is complete, or should I start now and hope that the avodart will not cause a drastic shedding phase and help me stabilize the hair that I currently have? I guess this really comes down to a game of timing.

It will be 5 months since my HT when the taping starts in June so I am hoping that the transplanted hair will already be popping up. Also, most of the hair that I am losing is from the front hairline and temples. The crown seems to be doing ok.

Thanks again for your time and I would also be interested in undergoing a transplant with your team following the taping.

I really do not have a clear answer to your situation. In general, Propecia or Avodart will not be as effective on your front and temple areas. They each work best on the top/crown areas of your scalp. I do not know if you will have more or less shedding as everyone has different results, different side effects, etc. Shedding isn’t seen by all men that start the medication. Really, only time will tell and there is no clear way to predict this.

It would be interesting to know if Avodart did indeed change your sexual side effect issues, as I would expect that it would not make it better. There’s not enough reported about Avodart dosing in the treatment of hair loss for me to suggest that bi-weekly pills are the way to go.

Doctor Rassam,

I have recently started taking anti-anxiety drug escitalopram clonazepam after consultation with a doctor.

Please let me know can I also take finasteride along with it.

This is a question for your prescribing doctor who knows your medical history. Generally speaking, finasteride does not seem to produce problems with most other medications.

Hey Doc – I emailed you a while back and wanted to thank you for your response on the blog. I recently upped my dosage of finastride to 2.5 mg proscar after a 10 yrs of propecia (1mg), based on my HT surgeons advice. My hairloss had really progressed so this was a clear course of action. I intially had great results on proetica in my early 20s.

1. My first question was related to dosing – I lift weights/workout intensely 6 days per week (often twice per day) and wondered if it would behoove me to split this dosage – 1.25 prior to weight lifting in the early evenings and 1.25 first thing in the morning, as recommended in your book.
2. My second question was, does taking Finastride with a multivitamin, a vitamin C, a vitamin E, vitamin D, Potassium, Magnesium, and Calcium – all in seperate pills, and a protein shake (organic from non hormone cows) in the morning before I do some intense cardio (I eat no real food till I come back from the gym) have any impact on Finastride absorbtion/effectiveness?

I have read your book and realize it is ok to take Finastride with food but this may be a tad different.

Thanks in advance

1. If you can keep up the regimen of taking a pill twice a day without forgetting, then go for it! Theoretically, it should give you a consistent level. Be sure to talk to your prescribing doctor to clarify this.
2. I do not believe taking finasteride with your supplements or food or exercise has any real impact on its absorption.