What can I take instead of finasteride?

Finasteride is a 5-alpha reductase inhibitor (5-ARI) that blocks the enzyme 5-alpha reductase from converting testosterone to dihydrotestosterone (DHT), a potent androgen hormone. Healthcare providers use low-dose finasteride to treat male pattern baldness (androgenetic alopecia or AGA) and promote hair regrowth. They use high-dose finasteride to relieve the lower urinary tract symptoms (LUTS) of an enlarged prostate (benign prostatic hyperplasia or BPH). Men may look for an alternative to finasteride because it may not work or it may be hard to live with the side effects, like sexual dysfunction. However, healthcare professionals have limited options for treating either condition.

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What can I take instead of finasteride?

If finasteride is ineffective or causes unbearable side effects, healthcare providers have a limited number of drugs to choose from. For hair thinning, a treatment alternative is Rogaine (minoxidil), a topical vasodilator that improves blood flow to the scalp and hair follicles.

For BPH, doctors may try another 5-ARI, dutasteride. It’s also an option for hair regrowth, but it’s not FDA-approved for that condition. However, the most common treatments for BPH are alpha-1 adrenergic receptor antagonists (alpha blockers), like tamsulosin or doxazosin. They work by relaxing the muscles in the bladder and the prostate, making it easier to pass urine. Finally, healthcare providers may use a phosphodiesterase type 5 (PDE5) inhibitor called Cialis (tadalafil). It’s better known as an erectile dysfunction drug, but it is also effective at reducing BPH symptoms without the sexual side effects that finasteride, dutasteride, and alpha blockers can cause.

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Finasteride alternatives cost comparison
Drug name	Price without insurance	SingleCare price	Savings options
Propecia (finasteride 1 mg)	$462 per 90, 1 mg tablets	$13 per 90, 1 mg tablets for generic finasteride at Kroger	See latest prices
Proscar (finasteride 5 mg)	$629 per 90, 5 mg tablets	$12 per 90, 5 mg tablets of generic finasteride at Kroger	See latest prices
Rogaine (minoxidil)	$68 per 180 mL of 2% solution	$29 per 180 mL of 2% solution of generic minoxidil at Walgreens	See latest prices
Avodart (dutasteride)	$5,536 per 90, 0.5 mg capsules	$31 per 90, 0.5 mg capsules of generic dutasteride at Kroger	See latest prices
Flomax (tamsulosin)	$110 per 30, 0.4 mg capsules of generic tamsulosin	$9 per 30, 0.4 mg capsules of generic tamsulosin at Kroger	See latest prices
Rapaflo (silodosin)	$335 per 30, 8 mg capsules	$22 per 30, 8 mg capsules of generic silodosin at Walgreens	See latest prices
Cialis (tadalafil)	$435 per 30, 5 mg tablets	$11 per 30, 5 mg tablets of generic tadalafil at Kroger	See latest prices

Prescription drug prices often change. These are the most accurate medication prices at the time of publishing in ZIP code 23666 as of 3/11/2026. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the link under “see latest prices” to see the latest drug prices.

Top finasteride alternative for hair loss

Rogaine

One reason you may be looking for alternatives to finasteride for hair loss is its potential for sexual side effects. Topical Rogaine avoids this risk and is an FDA-approved, over-the-counter (OTC) hair loss treatment. For men suffering from erectile dysfunction, loss of libido, or ejaculatory dysfunction with Propecia, switching to Rogaine could be helpful. However, Rogaine may not be quite as effective as Propecia, according to one study. If you decide to try Rogaine but experience skin irritation, there is a 5% foam formulation that may be less irritating.

Top finasteride alternatives for BPH

1. Avodart

Avodart (dutasteride) and Proscar (finasteride) have a lot in common. They are both DHT blockers that reduce DHT levels and shrink the prostate gland. A smaller prostate takes months to achieve, with maximum results occurring six to 12 months into treatment. However, there is a slightly increased risk of sexual dysfunction with these medications. More importantly, they both can suppress prostate-specific antigen (PSA) levels, a blood test used for prostate cancer screening. This might delay a diagnosis and increase the risk of prostate cancer reaching an advanced level before it’s detected.

2. Flomax

Alpha blockers are the foundation of BPH medical treatment. Blocking alpha-1 receptors causes the bladder outlet to relax, allowing a stronger urine stream and more complete bladder emptying. The mechanism has a quick onset of action, which is a significant advantage over finasteride. Flomax (tamsulosin) is a popular choice because it’s less likely to cause low blood pressure (hypotension) than other alpha blockers. There’s still a potential for side effects, such as dizziness, a runny nose, and ejaculation problems.

If ineffectiveness is the problem with finasteride, the healthcare provider may add an alpha-1 blocker rather than switch to one. Combination therapy has proven superior in some, but not all, studies. Jalyn combines a 5-ARI and alpha-1 blocker.

3. Rapaflo

Rapaflo (silodosin) is another alpha-1 blocker. Like Flomax, its effects are more selective to the prostate than the alpha blockers Cardura (doxazosin) and terazosin, so it is less likely to cause hypotension. It also beats finasteride in terms of a rapid response to therapy for BPH. 

4. Cialis

Erectile dysfunction (ED) and BPH are commonly experienced together. Cialis can treat the symptoms of both with a once-daily pill. Curiously, Cialis improved BPH symptoms significantly, but it did not improve measured urinary flow or bladder emptying in a clinical study. It might make sense to try Cialis instead of finasteride if you are experiencing both ED and BPH. If you do, keep in mind that headache, flushing, and upset stomach are some of the potential side effects.

Over-the-counter alternatives to finasteride

OTC Rogaine (minoxidil) is an effective treatment for male-pattern and female-pattern hair loss. 

Topical finasteride is an OTC substitute for oral finasteride, but it is not FDA-approved for the treatment of hair loss. In one study, topical finasteride was shown to increase hair density over a period of months without producing significant side effects. Because of safety concerns with absorbing it through the skin, the FDA warns people to talk to a healthcare professional before using these products.

Some dietary supplements are marketed as treatments for either male pattern baldness or BPH. These are not necessarily “natural” products; they are manufactured. The supplement saw palmetto has probably generated the most interest as a natural treatment for both BPH and androgenetic alopecia, but it’s uncertain what it actually does. Unfortunately, there is little evidence that it works for either BPH or male pattern hair loss. Rye grass pollen, stinging nettle, and antioxidant supplements might improve BPH, but quality evidence is lacking.

Natural alternatives to finasteride

From a medical point of view, the most effective natural treatments for both BPH and male pattern hair loss are managing stress, exercising regularly, and eating a healthy diet. 

In terms of diet, healthy hair and hair growth primarily require protein, biotin, zinc, and iron. People with BPH should avoid bladder irritants like alcohol, caffeine, and spicy foods. 

Various topical treatments—coconut oil, pumpkin seed oil, rosemary oil, peppermint oil, red ginseng oil, onion juice, and bhringraj oil—have been proposed as natural ways to slow male pattern hair loss or increase hair count on the scalp. The evidence for their effectiveness is limited, but these products are considered low-risk.

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How to switch to a finasteride alternative

You have the knowledge now to get a conversation started with the healthcare professional prescribing finasteride. Discuss your concerns, whether they are based on adverse effects or a lack of benefit. Bring up your ideas about alternatives while pursuing medical advice. Review your list of prescription drugs, OTC medications, and dietary supplements so you can avoid drug interactions. A realistic goal of the appointment is that a decision is made that you are comfortable with, whether that means continuing finasteride or starting an alternative medication.

Choosing the right path for hair loss treatment

There is no cure for a receding hairline, but drugs like finasteride and minoxidil can slow the progress of male pattern baldness and sometimes produce noticeable hair growth. If they don’t work, the first step is to talk to a dermatologist. For hair restoration, the only proven treatment is a hair transplant. 

Choosing the right path for BPH treatment

An enlarged prostate is a chronic and progressive condition, but symptoms can be managed and, in many cases, improved. Drug treatment is the most effective way to treat BPH symptoms. If symptoms do not improve or side effects are a problem, treatment options are limited. The first step is to get medical advice from a urologist about switching to another drug, taking more than one drug, or undergoing surgery.