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dutasteride and glutathione use different hepatic enzyme families Oral glutathione bioavailability / Approximately 10-20% after first-pass metabolism IV glutathione concern / Higher systemic levels may modulate Phase II enzyme activity more significantly Suggested dose separation / At least 2 hours between oral glutathione and dutasteride Liver monitoring / Check ALT and AST at baseline and every 6 months if using both long-term DHT suppression concern / No evidence that glutathione blunts dutasteride's 5-alpha reductase inhibition Who should avoid combining / Patients with pre-existing hepatic impairment (Child-Pugh class B or C) How Dutasteride Is Metabolized in the Liver Dutasteride is a dual 5-alpha reductase inhibitor (types I and II) approved by the FDA for benign prostatic hyperplasia and widely used off-label for androgenetic alopecia

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