Dutasteride is a so-called second generation dihydrotestosterone (DHT) inhibitor produced by the pharmaceutical company GlaxoSmithKline. Like Finasteride (Propecia), it was developed to treat the enlargement of the prostate gland in men known as benign prostatic hyperplasia (BPH). As was the case during Merck’s Finasteride testing back in the 1990s, Dutasteride’s beneficial effects on hair loss became apparent during GlaxoSmithKline’s clinical trials of the drug as a treatment for BPH. Dutasteride was granted FDA approval as a drug to treat BPH and appeared on the market in 2003 branded as Avodart. For the purposes of treating BPH, the recommended dose is a 0.5 mg soft gel capsule once daily. It is important to note that at this stage, Avodart generic has not been approved by the FDA for the purposes of treating hair loss. If this ever occurs, like Finasteride it will only be approved for use by men.
In a repeat of the history of Finasteride’s development as a hair loss drug, GlaxoSmithKline set about conducting trials into the use of Dutasteride, their own DHT inhibitor, for the same purposes. However, the company shelved their plans for a drug to rival Finasteride in the market for hair loss treatments after phase 2 trials of Dutasteride had been completed. It is not clear why they didn’t go through with a final phase of testing the drug in preparation for its approval as a hair loss treatment but it has been speculated that market forces were responsible. The company had been going through a number of mergers which may have had an impact on continuity in decision making among their various divisions. In addition to this, Finasteride, while already established on the market as an effective hair loss treatment, had not been meeting Wall Street’s profit expectations. This may have been due to negative publicity surrounding the potential side effects of the drug as far as sex drive and sexual performance were concerned.
Dutasteride is a dual DHT inhibitor, meaning that it acts on both type I and type II of the enzyme 5-alpha-reductase. Results have shown that its use can lead to a 93% reduction in the conversion of testosterone into DHT in the body, much higher than the inhibiting ability of Finasteride. It is possible that executives at GlaxoSmithKline were uneasy about the fact that because their DHT inhibitor was more powerful than Finasteride, despite the fact that this led to increased benefits as far as hair loss were concerned, the drug might be too strong for a nervous market in which Finasteride was already underperforming.
Although not confirmed, the final phase of Dutasteride testing may once again be underway. In the meantime it has begun to be prescribed off-label for some men hoping that its powers to inhibit DHT will help them retain or grow back more of their hair than Finasteride is capable of achieving for them. Because its side effects may be more severe and neither the dosage nor the long term impact of the drug for the purposes of hair loss have been approved by the FDA however, there are many reasons to be wary about the use of Dutasteride in this way.
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