Briefing · 19 Oct 2026

Finasteride vs dutasteride for hair loss: what the trials show and what online clinics charge (2026)

Dutasteride grows more hair than finasteride in head-to-head trials, but it is not FDA-approved for hair loss, stays in the body for weeks rather than hours, and the big three online clinics do not prescribe it on its own. Here is the evidence, the trade-offs, and what the four clinics that do sell it charge.

By Daniel Frangulea, who reads the clinics’ own pages and writes down what they say. I am not a doctor and this is not medical advice. Every price here comes from the ledger and carries the date I last read it; the clinical claims are sourced at the foot of the page. If something is wrong, tell me and I will fix it and log the fix.

Short answer: in every head-to-head trial, dutasteride 0.5 mg grew more hair than finasteride 1 mg over 24 weeks, with a similar rate of side effects. It is also off-label for hair loss in the US, far slower to leave the body, and sold by only a handful of online clinics, at roughly two to three times the price of the cheapest finasteride subscription. For most men finasteride is still the sensible first drug; dutasteride is the second conversation, usually after a year on finasteride that has not done enough.

How the two drugs differ

Both block 5α-reductase, the enzyme that turns testosterone into dihydrotestosterone (DHT), the hormone that shrinks follicles in male pattern hair loss. The difference is coverage. Finasteride inhibits only the type II form of the enzyme; dutasteride inhibits both type I and type II, and both types are present in hair follicles, which is the biological reason to expect it to be stronger. It is also much longer-acting: finasteride clears the body in about a day, while dutasteride's half-life is around five weeks, so it keeps working for months after the last dose and takes as long to wash out.

The regulatory status differs too. Finasteride 1 mg has been FDA-approved for male pattern hair loss since 1997. Dutasteride's US approval is for prostate enlargement only; its use for hair loss is off-label here, even though South Korea and Japan have approved it for that purpose. Off-label prescribing is legal and common, but it means a clinician has to be comfortable making the call, which is part of why the biggest telehealth platforms leave it alone.

What the trials show

• The largest trial. A randomized, double-blind study of 917 men aged 20 to 50, run across 39 centres in nine countries, compared dutasteride at 0.02, 0.1 and 0.5 mg with finasteride 1 mg and placebo for 24 weeks. Dutasteride 0.5 mg significantly increased hair count and hair width compared with finasteride, and improved hair growth on panel photographic assessment; the number and severity of adverse events were similar across the treatment groups. The study was limited to 24 weeks. On the registry's secondary measure, the change in hair count within a 1.13 cm circle at the crown was 18.1 for dutasteride 0.5 mg against 12.1 for finasteride 1 mg.
• A smaller open-label trial. In 90 men aged 18 to 40 randomised to 0.5 mg dutasteride or 1 mg finasteride for 24 weeks, total hair count per cm² rose from 223 to 246 on dutasteride against 227 to 231 on finasteride, with comparable side-effect profiles.
• Reviews of the evidence. Two separate meta-analyses have concluded that oral dutasteride is more effective than oral finasteride for male pattern hair loss.
• The low-dose and intermittent options. Dutasteride at 0.1 mg daily appears to give results at least similar to finasteride, and a 2025 pilot in 60 men found that 0.5 mg three times a week increased hair density and thickness to a greater extent than daily finasteride, although it did not significantly increase hair count over finasteride, and sexual adverse events were similar across groups. These are small studies, but they explain why some clinics offer dutasteride in fractional doses.

Two honest caveats. All of these trials stop at six months, so nobody has a head-to-head result over the years you would actually take the drug. And "more hair" in a trial is a count in a tattooed circle on the crown; whether the extra is visible in the mirror varies from man to man.

Side effects: the same list, one important difference

Both drugs carry the same family of warnings: sexual side effects in a small minority (see the numbers in our finasteride guide), post-marketing reports of depression and of problems persisting after stopping, a lowered PSA reading, and a strict rule that women who are or might be pregnant should not handle the tablets. The trials above found the rates similar between the two drugs. The difference is what happens when you stop. Finasteride is out of your system within days; dutasteride lingers for months, so a side effect you want to reverse takes far longer to reverse. That is also why, on its US label, men on dutasteride are told not to donate blood until six months after the last dose, against one month for finasteride.

What online clinics charge

The cheapest published oral finasteride subscription in our index is about $20 a month. Dutasteride costs more, partly because it is compounded rather than dispensed as a stock generic, and because fewer clinics compete on it. Hims, Keeps and Ro do not sell oral dutasteride on its own; Keeps includes it only inside its compounded chew and drop formulations. The clinics that do publish a price:

Note the "combined with minoxidil" wording on two of those rows: it makes the price look competitive but means you cannot buy the dutasteride alone, and it makes side effects harder to attribute if you get one. The full list, with dates, is on the cheapest oral dutasteride page and the topical dutasteride page.

So which one?

Start with finasteride if you are starting from nothing: it is approved for the job, it is the cheapest prescription option there is, it clears fast if you dislike it, and for most men it does enough. Consider dutasteride if a year of finasteride has slowed the loss but not stopped it, if you are already comfortable with 5α-reductase inhibitors, and if you accept a longer wash-out in exchange for the extra effect. Whatever you choose, the clinician who prescribes it is the person to talk to about the switch; the clinics above will all ask what you have tried before.

Where to go next

• Cheapest oral finasteride and cheapest oral dutasteride, lowest first.
• Compare any two clinics side by side.
• The cost calculator for a full year's cost at each clinic.

Sources

• Gubelin Harcha W. et al., "A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia", Journal of the American Academy of Dermatology, 2014. jaad.org
• ClinicalTrials.gov NCT01231607, results: change in target-area hair count at week 24. clinicaltrials.gov
• Shanshanwal S.J.S., Dhurat R.S., "Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia", Indian Journal of Dermatology, Venereology and Leprology, 2017. ijdvl.com
• Georgetown Medical Review, "Finasteride and Dutasteride for the Treatment of Male Androgenetic Alopecia: A Review of Efficacy and Reproductive Adverse Effects", 2024. gmr.scholasticahq.com
• "Efficacy and safety of twice- or thrice-weekly dutasteride versus daily finasteride in men with androgenetic alopecia", JAAD International, 2025. jaadinternational.org
• Clinic prices: each clinic's own pricing pages as recorded in the index, with the date of the last check shown on every price.

This briefing compares published evidence, prices and terms. It is not medical advice: both drugs are prescription medicines, and a licensed clinician decides whether either is right for you.

Prices in this briefing come from the index, last re-checked 24 Oct 2026; the affiliate note on the home page explains what a partner link does and does not change. See the current ledger.