Dutasteride vs. Finasteride: What Is the Difference?

By Rosanna Sutherby, PharmD

October 01, 2020

BPH

Benign prostatic hyperplasia (BPH) affects about one-third of men over 50 and is present in 90% of men by the age of 85. BPH is a noncancerous condition in which the prostate gland is enlarged. The enlarged prostate can squeeze the urethra (the tube that passes urine) and cause problems with urination. Dutasteride and Finasteride are medications that treat BPH and can help alleviate symptoms and prevent complications.

What Are Dutasteride and Finasteride?

Dutasteride and finasteride are drugs typically used to treat symptoms of BPH or an enlarged prostate. Dutasteride is generic for Avodart, and finasteride is generic for Proscar and Propecia. These medications are also used to treat other conditions.

How Do Dutasteride and Finasteride Work?

Dutasteride and finasteride are both 5-alpha-reductase inhibitors. Five-alpha-reductase is an enzyme that changes testosterone to dihydrotestosterone (DHT), which makes the prostate gland grow and causes baldness in men. Dutasteride and finasteride work by blocking the action of 5-alpha-reductase, which increases testosterone levels. Higher testosterone levels help reduce prostate size and control hair loss.

What Conditions Do Dutasteride and Finasteride Treat?

Dutasteride is indicated for the following:

  • Improving symptoms of BPH
  • Reducing the risk of sudden urinary retention
  • Reducing the need for prostate surgery

Dutasteride may be used off-label (not FDA approved) to treat male pattern baldness.

Finasteride is indicated for the following:

  • Improving symptoms of BPH
  • Reducing the risk of sudden urinary retention
  • Reducing the need for prostate surgery
  • Treating male pattern baldness

Finasteride may be used off-label for the following:

  • Treatment of hirsutism (excessive hair growth in women in areas where men typically grow hair)
  • Prevention of prostate cancer

What Are the Side Effects of Dutasteride and Finasteride?

The most common side effects seen with dutasteride and finasteride include:

  • Impotence (inability to have or maintain an erection)
  • Decreased interest in sex
  • Problems with ejaculation
  • Pain, swelling, or discharge from breasts

Dutasteride and finasteride should not be used in children or pregnant women. Women who are pregnant or planning to become pregnant should not handle dutasteride capsules or broken or crushed finasteride tablets. These medicines can cause harm to developing male babies.

Men who take dutasteride should not donate blood until at least six months after their last dose of dutasteride.

If you have liver problems, talk to your doctor before taking dutasteride or finasteride. It may take longer to clear the medication from your body if your liver is not functioning properly.

What Medications Interact with Dutasteride and Finasteride?

Some medicines that are metabolized by your liver may interact with dutasteride. Before taking dutasteride, let your healthcare provider know if you are taking any of the following medications:

  • Clarithromycin
  • Ciprofloxacin
  • Diltiazem
  • Ketoconazole
  • Ritonavir
  • Verapamil

This list does not include all medications that may interact with dutasteride. Always discuss all your medicines with your pharmacist or prescriber.

Finasteride has fewer potential drug interactions than dutasteride. However, supplements, such as saw palmetto (Serenoa repens) may have additive effects when used in combination with finasteride.

Which Is Better – Dutasteride or Finasteride?

Dutasteride and finasteride have similar potential side effects and are used to treat similar conditions. However, finasteride may be used to treat hirsutism in women and to prevent prostate cancer. Dutasteride is not typically used for these conditions.

When comparing dutasteride and finasteride, a 2011 study found that both drugs are equally effective in reducing prostate size and treating BPH symptoms. A more recent study found that dutasteride is more effective in treating male pattern baldness than finasteride.

How Much Do Dutasteride and Finasteride Cost?

The average retail price for 30 dutasteride 0.5 mg capsules is about $160. The average retail price for 30 finasteride 1 mg tablets is about $70.

If your insurance does not cover your medication, you can use a prescription discount card to get the lowest prescription price.

What Are Prescription Discount Cards?

Prescription discount cards offer prescription savings when your insurance does not cover your medication or when the price with insurance is higher than the cost with a prescription savings card. Using a free Rx savings card can save you up to 80% or more off the retail price. You can use a ScriptSave WellRx discount card for the best discount at a pharmacy near you.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://emedicine.medscape.com/article/437359-overview#a5

https://www.wellrx.com/health-conditions/about/health-condition/benign-prostatic-hyperplasia/~default/

https://www.wellrx.com/DUTASTERIDE/drug-information/

https://www.wellrx.com/FINASTERIDE/drug-information/

https://www.mayoclinic.org/diseases-conditions/hirsutism/symptoms-causes/syc-20354935

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175703/

https://pubmed.ncbi.nlm.nih.gov/21631695/

https://pubmed.ncbi.nlm.nih.gov/27549867/

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