What information did you learn about Avodart’s effectiveness in treating androgenic alopecia at the Sept. ’05 conference in Sydney, Aust.? Any hope for female pattern hair loss?
Avodart (dutasteride) may have value in those men where Propecia (finasteride) fails to work, but as it is not FDA approved for treating hair loss I can not in good conscience wholeheartedly endorse it. It does not show value in women.
Dear Dr Rassman,
I am a hair restoration surgical trainee(I am thankful to say that my mentor is a very well respected Australian ISHRS member).I would like to respond to one of your recent patient questions regarding the availability of generic Propecia.
It appears that generic Propecia IS currently available from some online pharmacies under the brand names Finpecia and Finax(as an example visit this link- https://www.unitedpharmacies.com/Hair_page_3_c_3.html).
It appears that there are legitimate ways that some countries can get around the relevant patent laws.
With kind Regards
I am presenting this as it was sent to me. The consumers must determine if this approach works for them. I would not recommend it for US-based people (due to it not being quite legal), but my opinion isn’t shared by everyone.
A BaldingBlog reader named Greg originally posted this as a comment to a blog entry, but I’ve formatted it to make it easier to read and have reposted it here.
The FDA has found Avodart to be safe (for BHP). The side effects were very simliar if not a tad less then Proscar 5mg, which also was cleared by the FDA many years ago. I think Avodart should be indicated as a off label prescription in some instances.
- non-responders to Propecia
- When the loss of efficacy of Propecia becomes bothersome to a indivdual
One other interesting point is that the age group the FDA studied on Propecia (18-42) was quite younger than what Proscar/Avodart (50+ median age 66 approx) so the chances of sexual side effects will inherently be larger in this age demographic as opposed to Propecia… meaning the side effects are probably even closer then one thinks/ Propecia versus Avodart. The one draw back with Avodart is that there is no “human model” with type 1 suppression so there is a question on “long term” safety as with many drugs. As long as you dont have any side effects with Avodart, the long half life can only be beneficial with Androgentic Alopecia and the phase 2 studies show this. People held onto the hair they gained (even grew more) 12 weeks “after” the the medication was discontinued (0.5 mg/ 2.5 mg only). Proscar users saw a sharp decline in this time frame. I hope these facts are helpful in some way.
Thank you for your insight. I believe that what you said makes good sense. I would hope that I could adopt a similar view in an ethical/legal framework.
Hi.DR.RASSMAN, I would like to know if type 1 DHT causes hairloss?? or is it just type 2..?? Please let me know when you get a chance… and do you think they will becoming out with anything better then propecia in the near future???
Propecia is a type 2 competitive inhibitor of DHT and Avodart is a competitive inhibitor of both Type 1 and Type 2 receptors. I think that is what you are asking. There is no clear evidence that blocking both Type 1 and type 2 receptors is better. What we do know is the Avodart does drop the DHT level in the blood stream more effectively than Finasteride (90% vs 75%). What this means is suggestive that it might work better in some people. But I must state clearly that safety and effectiveness is the mainstay of the FDA and until we have a handle on these two issues, I believe it is better to stick to Finasteride.
Take a look at these two links:
If you are considering FUE, you must know this material.
2019-01-02 05:07:072019-01-07 08:35:18How to Avoid a Problem When You Have an FUE (From Reddit)
You have mentioned that Avodart is not yet approved by FDA. Do you know what the status is on them approving it? Is it in its beginning trial stages or are the trials mostly complete and the FDA is just evaluating all of the research before making a decision. Or have they rejected it all together?
Avodart was approved by the FDA for treatment of benign prostatic hyperplasia (BPH), in 2001. While I do not know which stage the trials are currently in, I am sure that the manufacturer of Avodart is doing all they can to speed up the FDA approval process for use in hair loss, if it is even at trials to begin with.
You have significant donor site depletion. This problem is caused by over-harvesting the grafts from your FUE three months earlier. The only thing you can do is to get Scalp MicroPigmentation, which will hide the balding spots, but it will not add hair.
2018-04-12 06:06:162018-06-21 08:57:49I Have Let My Hair Grow Out 3 Months and the Back of My Head Looks like It Is Balding
Hello Dr. Rassman.
Thank you for taking the time to respond. I also wanted to ask you about going on Avodart (Dutasteride) or it’s Generic Dutagen. I have been on Propecia since 1999, and I think it is no longer working. I read Merck’s official report on Propecia’s 5 year efficacy, and it looks like after 5 years Propecia stops growing any hair at all, and it’s ability to keep hair is weakened. Dutasteride appears to block 93% of DHT production, where Propecia can only block 38-45% DHT. Can I get a prescription form you or Dr. McClellan? I am noticing that my “own” non-transplanted hair is thinning, and hopefully the Dutasteride or it’s generic version can stop any more loss.Also, I am using Nizoral shampoo (Ketoconazole) 2 times a week, and Head and Shoulders shampoo (Pyrithione Zinc) on the other days. Is it safe to mix the Ketoconazole and P. Zinc? A friend told me that the P. Zinc can cause miniaturization of the hair follicle, and mixing the 2 shampoos can have disastrous results. Then on the the other hand, many people on online hair loss forums are saying it is fine to mix the two shampoos. Only using Nizoral 2x a week does not stop my newly acquired incessant itching. It would be great if I knew it was safe to use Ketoconazole and P.Zinc.
Thank you so much for you time, I’m sure you hear all these worries all of the time. Now that I see my new hair sprouting, I want to keep it growing, and keep or grow more of my own.
Here is a link to some of my other posts with my comments on Avodart. I will make a decision with regards to prescribing Avodart in early September, after I return from the International Society of Hair Restoration Surgery meetings in Sydney, Australia.
With regard to the various questions you had concerning the shampoos you mentioned, I really do not know the answer, as many people respond differently to each. Experiment with each and when you find something working, then stick to it. Mixing shampoos should not be a problem.
In Medscape today, there is an article with the warning of the above title. “There are a number of pitfalls for patients, noted study co-author Douglas Sipp of Keio University School of Medicine in Tokyo.
“It is a problem for patients because there are inevitable risks in any invasive procedure, the vast majority of stem cell treatments being advertised online show exceedingly poor evidence of efficacy, they are costly and not reimbursed by most insurance, and more generally, the waste of time and resources on over-promoted quack remedies diverts these away from investment and use of in scientifically credible medicine,” Sipp said by email.”
In the hair industry, more and more such clinics are appearing almost weekly. There are two important issue: (1) the risks may not be inconsequential to your overall health and the health of your scalp and hair, and (2) they will be fleecing you for the money in your pockets.
2020-05-10 12:24:252020-05-10 12:24:25Baby Toupee (Saturday Night Live)
