Is bicalutamide (Casodex) used for female pattern hair loss?

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From the FDA Drug Label

Bicalutamide tablets are not indicated for use in females. The FDA drug label does not answer the question.

From the Research

Bicalutamide may be considered as an off-label treatment option for female pattern hair loss, particularly in cases where other treatments have failed or are not tolerated, as suggested by recent studies 1, 2. When considering treatment options for female pattern hair loss, it is essential to weigh the potential benefits and risks of each medication. Bicalutamide, an anti-androgen medication primarily approved for treating prostate cancer in men, has been recently studied for its potential use in female pattern hair loss.

  • The most recent study published in 2022 1 suggests that bicalutamide may be a promising option for treating female pattern hair loss, with a favorable safety and tolerability profile.
  • Another study published in 2025 2 also supports the use of bicalutamide for female pattern hair loss, highlighting its potential benefits in improving Sinclair grading in such patients. However, it is crucial to note that bicalutamide is not FDA-approved for this indication, and its use in women may be associated with potential serious side effects, including liver toxicity and teratogenicity (risk of birth defects) 3, 4, 5.
  • Other treatment options for female pattern hair loss, such as topical minoxidil, oral spironolactone, and oral finasteride, may be considered as first-line treatments due to their established efficacy and safety profiles.
  • Ultimately, the decision to use bicalutamide for female pattern hair loss should be made on a case-by-case basis, taking into account the individual patient's medical history, potential risks and benefits, and preferences, under the guidance of a dermatologist or healthcare professional.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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