Dutasteride vs. Finasteride for Benign Prostatic Hyperplasia: How They Compare

If benign prostatic hyperplasia (BPH) symptoms are interfering with your daily life, medications can help. But how do you choose the right treatment? Some BPH medications treat urinary symptoms only. Others help target their underlying cause — an enlarged prostate. Two common options that help reduce the size of your prostate include dutasteride (Avodart) and finasteride (Proscar).

Understanding the difference between finasteride and dutasteride can help you have an informed conversation with your prescriber about which BPH medication may be right for you. Below, we’ll cover six ways to compare finasteride versus dutasteride.

1. Dutasteride and finasteride are similarly effective for BPH

Both dutasteride and finasteride are 5-alpha reductase inhibitors. These medications work by blocking testosterone from changing to dihydrotestosterone (DHT) in the body. DHT is a male sex hormone that can lead to an enlarged prostate. 

By decreasing DHT levels, dutasteride and finasteride help reduce the size of your prostate. This can make it easier to pee. It can also lower the chance that you’ll need BPH-related surgery.

Overall, dutasteride and finasteride seem to work similarly well for BPH, and experts don’t recommend one over the other. A head-to-head clinical trial compared dutasteride with finasteride to see how well they work for BPH. Both medications effectively reduced prostate size, with similar findings after 3 months and again after 1 year. Both medications also improved urine flow and other BPH symptoms.

Keep in mind that even though dutasteride and finasteride are similarly effective, your prescriber may prefer one over the other for you. This is often based on factors such as your medical history, other medications you’re taking, and insurance coverage.

2. Dutasteride and finasteride are typically combined with different medications to treat BPH

Dutasteride and finasteride are both FDA approved on their own to treat BPH. But they can take up to 6 months to improve your symptoms. Since these medications don’t work right away, your prescriber may recommend combining dutasteride or finasteride with a medication that offers faster symptom relief, such as an alpha blocker. But dutasteride and finasteride are typically combined with different alpha blockers.

Dutasteride is approved for use in combination with tamsulosin (Flomax). Tamsulosin doesn’t affect prostate size, but it can help with urinary symptoms. Both medications are available on their own, but they also come in a combination pill called Jalyn.

Finasteride is approved for use in combination with doxazosin (Cardura). Like tamsulosin, doxazosin is an alpha blocker that helps with urinary symptoms.

EXPERT PICKS: WHAT TO READ NEXT

• Medications that can worsen benign prostatic hyperplasia (BPH). Be aware of medications to avoid if you have an enlarged prostate.

• Can BPH affect your sex life? Get answers to frequently asked questions about the prostate and sexual function.

• Best BPH medications. Here’s a list of common BPH medications and how they can help relieve urinary symptoms.

Good to know: Dutasteride and finasteride are FDA approved in combination with different alpha blockers. But your prescriber may prescribe an off-label combination. For example, they may decide to combine finasteride and tamsulosin. This is still considered a safe option, even though it isn’t specifically FDA approved.

3. Finasteride is also approved for male pattern hair loss; dutasteride isn’t

Finasteride is also available under the brand name Propecia for hair loss in men. This is because in addition to enlarging the prostate, DHT can also contribute to hair loss.

The typical Propecia dosage for male pattern hair loss is 1 mg daily, while the dosage of finasteride for BPH is 5 mg daily. Keep in mind that while both medications contain finasteride, they’re not interchangeable.

Dutasteride, on the other hand, isn’t FDA approved for hair loss. But it’s sometimes prescribed off-label for this purpose. In fact, some research shows that dutasteride lowers DHT levels in the scalp more than finasteride.

4. Dutasteride and finasteride have different dosages

Dutasteride comes as 0.5 mg capsules. You typically take it by mouth once daily, with or without food. But you shouldn’t chew, crush, or open the capsules.

Finasteride for BPH comes as 5 mg tablets. You’ll typically take it by mouth once daily, with or without food. And you shouldn’t chew or crush the tablets.

Neither finasteride nor dutasteride comes in a liquid form. But some people may find it easier to swallow a capsule than a tablet, or vice versa. So the dosage form they come in may play a role in which option is best for you.

5. Dutasteride and finasteride have similar side effects

Dutasteride and finasteride can cause similar side effects. Common examples include:

• Erectile dysfunction

• Decreased sex drive

• Ejaculation problems

• Gynecomastia (enlarged breasts in men)

Side effects of these BPH medications often improve or go away over time. But tell your prescriber if any start interfering with your daily life.

There are reports of mental and physical side effects that continue long-term after stopping finasteride. This is referred to as post-finasteride syndrome (PFS). PFS is also possible after taking dutasteride. Talk to your prescriber about your risk of PFS based on your medical history before taking either of these medications.

What are the serious side effects of dutasteride and finasteride?

Dutasteride and finasteride can also cause more serious side effects. These include:

• Allergic reactions. Although not technically a side effect, severe allergic reactions, including anaphylaxis, are a risk with these medications. Seek immediate medical attention if you have difficulty breathing, hives, or swelling of your face, tongue, or throat.

• Increased risk of prostate cancer. All 5-alpha reductase inhibitors may increase the risk of a serious form of prostate cancer. The overall risk is small, but it’s best to discuss your personal risk and family history of prostate cancer with your prescriber before taking either medication.

• Harm to a fetus. Women shouldn’t take or even touch dutasteride or finasteride if they’re pregnant or planning to become pregnant. Exposure to dutasteride or finasteride can harm a developing fetus.

6. Dutasteride and finasteride have different interactions to consider

Dutasteride is broken down by certain liver enzymes (proteins). Some medications can block these enzymes. This leads to higher dutasteride levels in your body and an increased risk of side effects. Examples of medications that interact with dutasteride include:

• Ritonavir (Norvir)

• Paxlovid (nirmatrelvir / ritonavir)

• Clarithromycin (Biaxin)

• Ketoconazole

• Verapamil (Verelan)

• Diltiazem (Cardizem)

Finasteride isn’t known to have any major drug interactions. So it may be a better option if you’re taking medications that interact with dutasteride. Your prescriber and pharmacist can review your medication list to determine if there are interactions to consider.

How to save on finasteride and dutasteride

Finasteride and dutasteride are available as brand-name medications as well as lower-cost generics. GoodRx can help you save over 85% off the average retail price of either medication.

With a free GoodRx discount, generic finasteride’s price is as low as $8.99 at certain pharmacies for a 30-day supply.

Generic dutasteride’s price is as low as $12.00 for a 30-day supply with a free GoodRx discount. If you have commercial insurance, you can also access brand-name Avodart for as little as $5 per month using the manufacturer’s copay card.

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Written by:

Patricia Weiser, PharmD

Patricia Weiser, PharmD, has 16 years of pharmacist experience. She previously held positions as a community pharmacist, pharmacy manager, and hospital pharmacist.

Edited by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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