The pharmacy mistake ruining dutasteride (and how to fix)

追加: 2026-06-06

[00:00:00]Here's exactly how to tell if your oral dutastasteride is formulated properly.

[00:00:03]If it is, you've got nothing to worry about and hair gains are likely right around the corner. If it isn't, or if you've been using dutastasteride and you've only noticed continued hair loss, your dutastride might have a fundamental problem in the way it was made. And this is a far bigger issue than people care to admit. It particularly impacts compounding pharmacy versions of dutastasteride that combine dutasteride plus minoxidil plus biotin into a single pill. My name is Rob English. I am a researcher who focuses on hair loss disorders. I'm on the editorial board of a dermatology journal. I publish papers related to hair loss. I referee manuscripts for hair loss disorders. And I make content like this for individuals who are fighting hair loss and looking to maximize their hair gains.

[00:00:46]If you have androgenic alipcia or male pattern hair loss, chances are that you've considered treatments. Some of the most popular hair growth medications, minoxidil and finasteride, don't require specific formulations to get absorbed by our body. These things can be taken separately or compounded together or grinded up into powders. And often times they're going to absorb roughly the same within your body and have roughly the same effects. The same is not true about oral dutasteride. Oral dutasteride has to be emulsified oftentimes with mono and diglyceride so that it can be absorbed by the body and then distributed to have an effect at the level of the hair follicles. And it's for this very reason that when dutastasteride was originally FDA approved for benign prostatic hyperlasia, it had to be formulated as a soft gel at.5 milligs. That soft gel encapsulated liquid with mono and diglycerides to help the dutasteride absorb. Fast forward decades later, dutasteride is now one of the most popular off-le treatments for hair loss related to androgenic alopecia. It reduces DHT better than finasteride. It leads to bigger hair gains than finasteride. And more and more people are making the switch to this medication to maximize their hair gains. Except a growing number of people who make the switch from finasteride to gutastasteride do so only to feel like their hair loss actually gets worse.

[00:02:07]They feel like their previously stable hairline begins to recede again. They feel like their hair shedding increases and their density overall begins to decrease. Now, we made a video on this not too long ago about switching from finasteride to dutastasteride only to watch your hair gains worsen. If you want to dive into those, please watch that full video. I'm going to cover them really quickly right now. The first possibility is that if you notice these changes within the first 1 to 3 months, this could actually be a treatment induced tigen oflovium shed, which is actually a good thing. Again, watch the video for more information. In this case, you wouldn't want to stop treatment. The second possibility is that there is potential evidence that finasteride and dutastasteride have different effects on type 3 five alpha reductase and that depending on the studies that you like to site type 3 five alpha reductase may be causally implicated in a subset of androgenic alipcia sufferers and that finasteride could potentially do a little bit better job of targeting that versus dutasteride. It is an extremely specific and extremely speculative hypothesis.

[00:03:08]Watch the video for more information.

[00:03:09]But the third possibility is the one that's most important. It's the topic of this video, and it's the one that I think is responsible for the overwhelming majority of cases of people who switch from finasteride to dutastasteride orally and just notice a worsening of their hair loss. It's that the dutastride that they bought is improperly formulated. Now, we've covered this topic extensively before.

[00:03:30]For more information, read our two posts about dutastasteride formulations. The main thing here is that a growing number of people are buying dutasteride compounded with other medications or ingredients for convenience or added effect. So we see compoundingies in the US buying powdered dutasteride, combining it with things like oral minoxidil or biotin or vitamin D and then selling that as an all-in-one pill so that people who want to use dutastasteride plus minoxidil for example don't have to take the tablet of minoxidil and the oral dutasteride soft gel separately. Unfortunately, what you gain in convenience here, you actually lose in potential efficacy for dutasteride. Because when these compoundingies buy the raw dutastasteride in powdered form and then they mix this all together into a super capsule, they almost never add in emulsifiers like mono and diglycerides to then enhance the absorption of the dutastasteride. That's the exact reason why it's formulated in a soft gel in the first place. In fact, there are forum posts online where you can read about pharmacists who have gone in and felt like their switch from finasteride to dutastasteride hurt their hair gains.

[00:04:37]And they tested brands of their dutastride providers that were providing them in a capsuled form only to discover that they weren't being properly emulsified and that the effect wasn't as big as when they were previously using finasteride which doesn't suffer from the same bioavailability concerns. Now, when we were starting our teleahalth brand Ulo, we were very concerned about this. We didn't want to sell a formulation of dutastasteride that was compounded with minoxidil for example, but that in doing so reduced the efficacy of dutastasteride itself. And so we reached out to ask more about formulations. And everyone that we contacted in the compounding pharmacy world told us that they were just using the powder for both medications, combining them together, and not throwing in any emulsifiers. In fact, one of the people that we spoke with said that their customers are getting great results. So, why would they even be concerned about this? And so, we decided to call their bluff. And what we ended up doing is finding an individual who got a baseline level of DHT. That's the hormone that dutastasteride reduces.

[00:05:41]And we had this compounding pharmacy send us 3.5 milligram capsules of dutasteride in their powdered form, the exact way that they send it out to customers all across the US when they sell them dutasteride plus minoxidil combined together. And we had this individual do a baseline serum DHT test and then take three dutasteride capsules, so 1.5 milligrams, and then retest 12 hours later. Now, the original pharmacocinetic data on dutastride suggests that a dose this big over just a 12-h hour period should reduce DHT levels by over 90% throughout the body.

[00:06:19]And yet, when our individual retested their blood the next day, their DHT levels only reduced by around 13%. So a massive miss which then further underscored the exact problem that we were concerned about in the first place.

[00:06:36]For this reason, our brand decided that we were never going to compound oral dutastasteride with other medications.

[00:06:43]Instead, we were always going to sell the oral dutastasteride in its soft gel form and specifically ABrated oral dutasteride. That's oral dutasteride that according to the FDA is proven to be bioequivalent to Avdart, which is the original soft gel for dutastasteride that was approved by the FDA for BPH.

[00:07:06]And so for our brand, if somebody wants to use oral dutastasteride and minoxidil, those things are separated out because we don't want to compromise on bioavailability. But as we've made content about this topic, we've also received a ton of questions from people concerned that maybe their oral dutastasteride that they're using is not bioequivalent to abduct. The good news is that there is actually a way to answer this question. Having a soft gel oral dutastasteride is a good benchmark because it's very likely that if it's formulated as a soft gel, the only reason that you do that is to include those mono and diglycerides in their liquid formulation. So a soft gel of oral dutastasteride is usually a great indication that it's probably bioequivalent. But there is an even better way to do this. One that not only tracks soft gels but any other form of oral dutasteride that has proven bioequivalence against avdart by the FDA through pharmaccoinetic testing. The FDA has something called an orange book. I will link it below. And if you search for the term dutasteride, you will see all of the names of companies and manufacturers who have submitted and proven that their oral dutastasteride formulations are bioequivalent to abbod.

[00:08:21]And this is so critical because that's the exact formulation that was studied not only for dutasteride's effects on lowering DHT, that hormone causally linked to androgenic alipcia, but also the studies showing that dutasteride outperformed finasteride for treating androgenic alopecia. So you want bioequivalence. You want to make sure that the dutastasteride that you are using is the same as the dutastasteride in those clinical studies. And fortunately the FDA publishes this information. I am going to link all of the names of the companies and manufacturers that have gone through this process and proven bioequivalence.

[00:08:57]Our brand that we partner with at our compounding pharmacy is Epic Dutasteride and it's sold under this brand with a proven AB rating for bioequivalence. If you're interested in your dutastasteride, check out if the brand is sold by any of the companies or manufacturers listed in the orange book.

[00:09:17]I'll share this with you below. And if you're outside of the US, it's also very likely that there's an equivalence to this orange book in your own FDA related systems. So with a bit of research, you'll be able to find some sort of equivalent to the Orange Book. Or maybe you'll even find the brand that you're using is already listed in the US Orange book because a lot of these companies are global. All right, that's everything. I hope this video was helpful. This video is really for anybody who is using oral dutastasteride. I don't care if it's from Ulo, our brand, or from anybody else. I do care that the formulation that you're using is bioequivalent to the formulation studied and proven to outperform finasteride with respect to androgenic alopecia. That's what matters most here and I want to minimize the possibility that you're selling yourself short for something that you think should be more effective than say an FDA approved medication at treating this condition. Okay, that's it for today. I hope this video was useful. I will see you next time and have a great