Propecia vs Avodart

[KHH]

Which is better, Avodart og Propecia?

 

[Aplunk1]

Propecia is only approved for hairloss. But, given purpose of the two drugs, Avodart is more effective.

 

[Siberian]

Which is better, Avodart og Propecia?

Check out: http://www.dutasteride.org/dutasteride/ ... esults.htm

 

[Steve4263]

That link pretty much says it all and from what I have been reading in these forums it looks like dustasteride is more effecient for growing hair then finastreride.

 

[Jacky81]

And you need 5 mg (FIVE) of Finasterid to have a comparable effect like with dutasteride. Please consider this!!! Who takes 5mg finasteride every day??

 

[Siberian]

And you need 5 mg (FIVE) of Finasterid to have a comparable effect like with dutasteride. Please consider this!!! Who takes 5mg finasteride every day??

Right, and what still makes no sense to me is...

If Proscar (5mg finasteride) clearly blocks more DHT than Propecia (1mg finasteride), why did Merck choose the 1mg dosing for it's hairloss treatment? Why does Merck insist that 5mg finasteride isn't any more effective than 1mg? It's as if Merck is saying reducing DHT levels beyond 60% (or whatever Propecia does) just doesn't matter... like it's some sort of threshold of effectiveness.

It makes me wonder if the key difference between dutasteride and finasteride is that dutasteride blocks BOTH enzymes, and the fact that it ends up blocking more DHT than finasteride is only incidental and unimportant. That would explain why Propecia and Proscar are supposedly equally effective attreating hairloss, and yet dutasteride is better than both.

Or... was Merck afraid of the side-effects of 5mg finasteride, so they reduced the dosage to 1mg and lied about it being just as effective as 5mg?

It's all so darn confusing. Especially since, unlike finasteride, apparently the effectiveness of dutasteride IS dosage-dependent.

 

[Aplunk1]

Still, Phase II studies on Dutasteride show that it regrows much more hair.

 

[Siberian]

Still, Phase II studies on Dutasteride show that it regrows much more hair.

I agree... I'm not arguing with the results at all. In fact, I'm trying to find someone to write me a prescription right now (cheaper than using an online place). I agree it's a more effective treatment than finasteride.

I'm just curious why it's better, since it's *apparently* not simply that it reduces DHT levels beyond that of finasteride. On the surface, if taking Proscar is no more effective than taking Propecia, then one would think taking dutasteride would be no better than either as well. Yet it is. Why?

I'm guessing, as someone else once pointed out, that blocking the type 2 enzyme past a certain point just doesn't matter. The only other difference between dutasteride and finasteride is that dutasteride blocks/competes with the type 1 enzyme thing and finasteride doesn't, so maybe that's the critical factor here.

 

[Aplunk1]

Half-life factors into this as well.

Dutasteride is a faster-acting weapon against DHT, too.

 

[WiseJoeyD]

Hasn't really helped me. Temple recession and continued diffuse thinning of remaining frontal hair. Crown a bit below baseline last year. In all a bit rubbish (for want of a more eloquent turn of phrase)

 

[Aplunk1]

Joey,
please make a comparison between Propecia and Avodart. Which one do you feel works better?

 

[Anderz]

Still, Phase II studies on Dutasteride show that it regrows much more hair.

I agree... I'm not arguing with the results at all. In fact, I'm trying to find someone to write me a prescription right now (cheaper than using an online place). I agree it's a more effective treatment than finasteride.

I'm just curious why it's better, since it's *apparently* not simply that it reduces DHT levels beyond that of finasteride. On the surface, if taking Proscar is no more effective than taking Propecia, then one would think taking dutasteride would be no better than either as well. Yet it is. Why?

I'm guessing, as someone else once pointed out, that blocking the type 2 enzyme past a certain point just doesn't matter. The only other difference between dutasteride and finasteride is that dutasteride blocks/competes with the type 1 enzyme thing and finasteride doesn't, so maybe that's the critical factor here.

Androgen alopecia is affected by the total amount of androgens. Dutasteride makes you less androgenic, than finasteride, and that is why it is more effective.

Proscar is more effective than Propecia, but the difference is not that big - because 5mg of finasteride won't block T->DHT conversion much better than 1mg will.

 

[WiseJoeyD]

Joey,
please make a comparison between Propecia and Avodart. Which one do you feel works better?

Well, I wonder if things would be worse off had I not taken anything!

I certainly haven't seen any stop to the loss. Noted, with my usual mild distain, the enlarged really thin balding spot on my crown; looks like even dutasteride didn't really save my crown that much.

I think my body just gets it's kicks from any form of testostreone flowing around. For the last 2 years i've used two powerful anti-DHT treatments with no real cessation or regrowth.

Course, I'm happy I tried and I still want to try topical anti-androgens or mayb even go for all that copper nonsense!

Future Plans: Possibly go the whole hog and go till January next year [2 years on it]. Then I can come back as a true Failure! I'm still hoping for something but in the meantime spironolactone will be considered.

 

[camobear777]

Been on Propecia for 15 months now and now relay seeing a decline. I am seeing a Dermatologist next week and was wondering if I should consider dutasteride. I am willing to give Propecia some more time but wanted to get some more opinions before I do anything. Cheers

 

[Bryan]

Still, Phase II studies on Dutasteride show that it regrows much more hair.

It's a little misleading just to compare the amount of regrown hair. To get a better picture of their relative efficacies against hairloss, it's better to compare the two drugs versus placebo. And Glaxo's trial results show that dutasteride (at the standard Avodart dosage of 0.5 mg/day) was 21.7% more effective than finasteride (at the standard Proscar dosage of 5 mg/day), when compared against placebo. I suppose it's up to each individual to decide for himself if that qualifies as "much more effective" or "a little more effective" or "slightly more effective", or whatever.

Bryan

 

[Bryan]

Still, Phase II studies on Dutasteride show that it regrows much more hair.

I agree... I'm not arguing with the results at all.

It regrows what I would call a LITTLE more hair.

I'm just curious why it's better, since it's *apparently* not simply that it reduces DHT levels beyond that of finasteride. On the surface, if taking Proscar is no more effective than taking Propecia, then one would think taking dutasteride would be no better than either as well. Yet it is. Why?

I think it IS simply because it reduces DHT levels beyond that of finasteride. I think you're making a fundamental error when you claim that Proscar is no more effective than Propecia. I think it is, and in approximately the same proportion that Proscar reduces DHT more than Propecia.

I'm guessing, as someone else once pointed out, that blocking the type 2 enzyme past a certain point just doesn't matter.

I see no justification at this time for making such an assumption.

The only other difference between dutasteride and finasteride is that dutasteride blocks/competes with the type 1 enzyme thing and finasteride doesn't, so maybe that's the critical factor here.

I think the reason for dutasteride's greater effectiveness against hairloss is partly (maybe mostly) its greater effectiveness than finasteride at inhibiting the type 2 enzyme (98%-99% for dutasteride, versus 90% for finasteride), and partly the more modest inhibition of the type 1 enzyme (~50% or so).

Bryan

 

[Siberian]

I'm guessing, as someone else once pointed out, that blocking the type 2 enzyme past a certain point just doesn't matter.

I see no justification at this time for making such an assumption.

I phrased that wrong. I shoulda said "once you've blocked the Type II enzyme, taking more finasteride just doesn't matter."

There's an interesting Merck transcript somewhere (I'll try and find it) where the Merck rep tells us that literally taking 80mg of finasteride per day doesn't reduce DHT much beyond taking 1mg per day... it levels off after that 70% plateau, or whatever it is, regardless of the dosage (beyond 1 mg or so).

My assumption is that since finasteride only really deals with the Type II enzyme, it can only stop so much DHT, regardless of the dose. There's still that Type I floating around, making DHT, even if we swallow enough bottles of finasteride do kill ALL our Type II enzyme.

So dutasteride picks up where finasteride leaves off by blocking the Type I enzyme too, and we continue past that 70% DHT reduction threshold, thus getting more hair back.

IMHO, of course

 

[Bryan]

I phrased that wrong. I shoulda said "once you've blocked the Type II enzyme, taking more finasteride just doesn't matter."

Yeah, but you haven't blocked ALL of the type II enzyme just by taking Proscar. Only about 90% of it. You'll almost certainly do better if you block even more of it. I think that's a major reason why dutasteride is more effective than finasteride (at the typical doses of both drugs that are generally used).

There's an interesting Merck transcript somewhere (I'll try and find it) where the Merck rep tells us that literally taking 80mg of finasteride per day doesn't reduce DHT much beyond taking 1mg per day... it levels off after that 70% plateau, or whatever it is, regardless of the dosage (beyond 1 mg or so).

Yes, but notice the key parts of that statement, which are the words "much" and "levels off". DHT is definitely reduced by _some_ additional amount, but not by a whole lot. It's fairly level after taking only 1 mg, but not perfectly level.

My assumption is that since finasteride only really deals with the Type II enzyme, it can only stop so much DHT, regardless of the dose. There's still that Type I floating around, making DHT, even if we swallow enough bottles of finasteride do kill ALL our Type II enzyme.

So dutasteride picks up where finasteride leaves off by blocking the Type I enzyme too, and we continue past that 70% DHT reduction threshold, thus getting more hair back.

The type II enzyme is much more "hair specific" than the type I enzyme, so I continue to believe that dutasteride's somewhat better performance over finasteride is accounted for partly (mostly?) by its more complete inhibition of the type II enzyme, and partly (a lesser portion?) by its partial activity against the type I enzyme.

Bryan

 

[Aplunk1]

Okay, now that dutasteride is understood to inhibit a higher amount of Type II enzyme (~98%), and that finasteride only inhibits ~90% of Type II enzyme, it's clear the dutasteride will probably yield better hair growth.

As a dutasteride user, I'm concerned about maintenance and long-term efficacy. Is there any evidence that this drug will give me the long-term efficacy of finasteride (if not better)?

I know the Phase III studies weren't completed (which I believe was a total financial reason), but I'd like to think that dutasteride is suggested to provide good long-term efficacy. It's half-life is significantly longer, too. Does this play a role in perhaps yielding higher hair counts than finasteride over a period of 5+ years?

I'm sorry that I word things so confusing. But, I hope that my questions can be understood.

 

[Siberian]

As a dutasteride user, I'm concerned about maintenance and long-term efficacy. Is there any evidence that this drug will give me the long-term efficacy of finasteride (if not better)?

It's always been my opinion that the gradual drop-off in effectiveness of Propecia is a result of the remaining DHT, not a growing tolerance to the drug. After that initial 1-2 year spike of regrowth, the balding process is simply continuing due to the remaining DHT - just at a much slower rate than if you weren't taking the drug.

If this is true, then Avodart will give better regrowth over a longer period of time, and the eventual drop-off will be much less steep (and later).