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Home > Anti-aging Research > Proscar/Avodart

Avodart (dutasteride)

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  • Avodart (dutasteride) - rxlist.com - "AVODART (dutasteride) is a synthetic 4-azasteroid compound that is a selective inhibitor of both the type 1 and type 2 isoforms of steroid 5a-reductase (5AR), an intracellular enzyme that converts testosterone to 5a-dihydrotestosterone (DHT)"
  • Hair Loss Drug Propecia Carries Risk of Losing Something Else - NBC News, 3/10/17 - "It's a low risk— overall, just 1.4 percent of men who took the drugs suffered long-term erectile dysfunction. But it lasted a very long time: more than 3 ½ years after they stopped taking the drugs ... The younger the men, the bigger the risk ... The drugs are sold under the brand names Propecia, Proscar and Avodart and are known generically as finasteride and dutasteride ... It was a hard problem to fix. Taking Viagra or other drugs did not seem to help ... "I have hundreds of these patients," he told NBC News. "They have low libido. They have flat emotions. They see a woman, they say intellectually, 'I know I am supposed to be interested in you. But I am actually not interested in you'. They have muted orgasms, reduced volume of ejaculate, reduced penile sensation.""
  • Risk of Erectile Dysfunction Associated With Use of 5-α Reductase Inhibitors for Benign Prostatic Hyperplasia or Alopecia - Medscape, 10/20/16 - "5-α reductase inhibitor (finasteride or dutasteride) ... 5-α reductase inhibitors do not seem to significantly increase the risk of incident erectile dysfunction, regardless of indication for use. Risk of erectile dysfunction increased with longer duration of benign prostatic hyperplasia"
  • In Prostate Hyperplasia, Combo Pill Slows Progress - Medscape, 4/18/14 - "All men received lifestyle advice about caffeine and alcohol avoidance, fluid management, and bladder retraining. They were then randomized to watchful waiting (n = 373) or to daily treatment for 2 years with a single capsule containing the 5-alpha reductase inhibitor dutasteride 0.5 mg plus the alpha blocker tamsulosin 0.4 mg (n = 369) ... At the end of the study, the rate of clinical progression of benign prostate hyperplasia was 43.1% lower in the treatment group than in the watchful waiting group (18% vs 29%; P < .001) ... Similarly, improvements in hyperplasia symptoms and related quality of life were significantly greater the treatment group"
  • Follow-Up to REDUCE Study Shows Low Rate of Prostate Cancer Diagnosis - Science Daily, 1/22/13 - "The four-year REDUCE (REduction by DUtasteride of prostate Cancer Events) clinical study evaluated prostate cancer risk reduction in men taking dutasteride, a 5-alpha-reductase inhibitor (5ARI) typically used to treat enlarged prostate ... dutasteride decreased the risk of biopsy detectable prostate cancer by 22.8 percent compared to a placebo group ... few new prostate cancers were detected during the two-year follow-up in either treatment group and no deaths were reported. However, the former dutasteride group produced double the number of cancers than the former placebo group (14 vs. 7). Investigators hypothesize that any prostate cancer that may have been suppressed by dutasteride during REDUCE was no longer being suppressed for those subjects who did not continue on 5ARI therapy ... Overall, men in either group who took a 5ARI during the follow-up study tended to have fewer cancers"
  • Muscle Gain From Testosterone Not Hampered by Dutasteride - Medscape, 3/6/12 - "Sexual function was not significantly related to testosterone dose or testosterone concentrations during treatment, and did not differ significantly between placebo and dutasteride groups ... [T]he inhibition of testosterone's conversion to DHT by dutasteride had no significant effect on the ability of testosterone to exert its effects on muscle mass and strength, sexual function, erythropoiesis, plasma lipid levels, prostate volume, and sebum production"
  • Dutasteride Is Seen to Curtail Cancer Left in Prostate - NYTimes.com, 1/23/12 - "Two previous studies suggested that dutasteride and a similar drug, finasteride, could actually protect men from prostate cancer ... Three years later, the cancer had progressed in 54 men in the dutasteride group, or 38 percent, and in 70 men in the placebo group, or 48 percent"
  • The Impact of Current BPH Treatment on Sexual Function - Medscape, 10/13/11 - See table one.  Some of those medications were less than the placebo.  For example, Alfuzosin had a 3% ED rate but the placebo was 4%.  The article didn't cover gynecomastia which can be a problem with BPH treatments.  Some studies support letrozole to prevent gynecomastia.  I take a quarter tablet every other day.
  • Popular drugs for common male health problems can affect their sexual health - Science Daily, 3/7/11
  • Drugs for hair loss and benign prostatic hyperplasia may result in loss of libido, erectile dysfunction in men - Science Daily, 1/11/11 - "5a-reductase inhibitors (5a-RIs), while improving urinary symptoms in patients with benign prostatic hyperplasia (BPH) and possible hair loss prevention, produces significant adverse effects in some individuals including loss of libido, erectile dysfunction (ED), ejaculatory dysfunction and potential depression" - Note:  That goes back and forth.  One study claimed that finasteride improved sex after after six months of taking it.  Regarding gynaecomastia, if you're taking low dose letrozole to increase testosterone and to prevent aromatization it many also help prevent gynaecomastia.
  • PSA test better predicts cancer in men taking prostate-shrinking drug - Science Daily, 12/16/10 - "Dutasteride lowers PSA levels by about half within six months. But the researchers found that even a slight rise in PSA levels among men taking the drug was a stronger indicator of prostate cancer, particularly aggressive tumors that require early diagnosis and treatment, than rising PSA levels in men who took a placebo ... dutasteride reduced the risk of a prostate cancer diagnosis by 23 percent. Dutasteride appears to keep tumors small or shrink them to the point that they are less likely to be detected by a biopsy ... Over four years, PSA levels increased in 72 percent of men taking a placebo and only 29 percent of men taking dutasteride, the data show"
  • FDA Approves Dutasteride/Tamsulosin Combo Pill for BPH - Medscape, 6/18/10 - "daily use of the drug combination yielded significantly greater relief of BPH symptoms compared with either 0.5 mg dutasteride or 0.4 mg tamsulosin alone, as measured by point changes on the International Prostate Symptom scale from baseline (mean Δ, −6.2 vs −4.9 and −4.3; P < .001 for both). The difference was observed by month 9 and continued through month 24"
  • The Effect of Short-term Dutasteride Intake in Early-stage Prostate Cancer: Analysis of 148 Patients Who Underwent Three-dimensional Prostate Mapping Biopsy - Urology. 2010 May 14 - "transperineal three-dimensional mapping (TP-3DM) biopsy ... We observed a 24.3% decrease in the proportion of upstaging and/or upgrading of prostate cancer in men who received dutasteride at least 3 months before 3D prostate TP-3DM biopsy. Thus, the effect of dutasteride on prostate cancer may have implications for its potential use as a secondary chemoprevention agent" - See dutasteride at OffshoreRx1.com.
  • Avodart May Lower Prostate Cancer Risk - WebMD, 3/31/10 - "those who took the drug Avodart had a 23% lower risk of being diagnosed with prostate cancer over four years of treatment, compared to men who did not take the drug" - See Avodart (dutasteride) at OffshoreRx1.com.
  • Combination therapy more effective for enlarged prostate - Science Daily, 3/2/10 - "On the strengths of both dutasteride and tamsulosin, participants reported fewer symptoms, and we observed a 25 percent reduction in prostate volume ... subjects who received the combination therapy also showed a 50 percent reduction of prostate-specific antigen (PSA), a protein produced by both cancerous and noncancerous prostate tissue ... Compared with tamsulosin alone, the combination of drugs reduced the incidence of acute urinary retention by 67 percent and reduced the need for BPH-related surgery by 70 percent"
  • Dutasteride Reduces Risk for Biopsy-Detectable Prostate Cancer in Men at Increased Risk - Doctor's Guide, 12/1/09 - "Compared with placebo, active treatment also showed significantly lower risks for (respectively) HG-PIN (5.4% vs 3.5%; RRR, 34%; P = .0053), ASAP (5.1% vs 3.6%; RRR, 28%; P = .0274), AUR (7.1% vs 1.4%; RRR, 80.4%; P < .0001), BPH-related surgery (5.7% vs 1.4%; RRR 75.6%; P < .0001), and UTI (9.6% vs 5.8%; RRR, 40.8%; P < .0001) ... Similarly, there were significant reductions for mean prostate volume (18.7% increase vs 16.9% decrease; P < .0001) and IPSS (+1.14 vs -0.6; P < .0001), and slightly fewer high-grade tumours (Gleason score, 7-10) in the dutasteride group (7.5% vs 7.0%) ... These benefits were accompanied by significantly more frequent dutasteride-related adverse events (12% vs 19%; P < .0001), with dutasteride treatment showing increased frequencies of decreased libido (2.8% vs 5.5%), impotence (7.7% vs 10.9%), ejaculation disorders (0.5% vs 2.4%), and breast disorders (1.9% vs 3.5%)"
  • Diet, Drugs May Stop Prostate Cancer - WebMD, 9/24/07
  • Diet And Medications May Assist Prevention Of Prostate Cancer - Science Daily, 9/24/07 - "dutasteride, has reduced by 50 percent the number of cancerous biopsies among men with benign prostatic hypertrophy ... In one study of selenium, the incidence of prostate cancer was reduced by 49 percent over ten years ... Data already suggests novel uses of statins, commonly prescribed cholesterol-lowering agents, and insulin modulating drugs, such as metformin or the glitazones"
  • Treatment Found To Reverse Hair Loss - Science Daily, 6/11/07 - "one of each pair of twins was given 0.5 mg/day of the medication, the other receiving a placebo ... After both 6 and 12-month intervals, hair loss was found to not only have been halted in twins using dutasteride, but hair growth was actively improved"

Abstracts:

  • Effects of dutasteride on serum free-testosterone and clinical significance of testosterone changes - Andrologia. 2016 Mar 8 - "Serum free-testosterone levels were 20.4% higher after 1 month and remained constant thereafter ... These results indicate that dutasteride increases serum free-testosterone levels in BPH patients, particularly with low baseline free-testosterone levels, and the increase in free-testosterone may have further add-on impacts on their urinary tract symptoms"
  • Dutasteride in men receiving testosterone therapy: a randomised, double-blind study - Andrologia. 2014 Feb 6 - "We investigate the impact of dutasteride on prostate specific antigen (PSA) and prostate volume in men receiving testosterone (T) therapy ... Serum levels of PSA, T and dihydrotestosterone (DHT) and responses to the International Index of Erectile Function (IIEF) and Male Sexual Health Questionnaire (MSHQ) questionnaires were determined at baseline and at 3, 6, 9 and 12 months ... Men receiving dutasteride had a significant decrease in PSA (-0.46 ± 0.81 ng ml-1 ; P = 0.04) and in PV (-6.65 ± 11.0%; P = 0.03) from baseline over 12 months. DHT decreased significantly for men on dutasteride compared with men receiving placebo (P = 0.02). When compared with men who received placebo, men who received dutasteride demonstrated nonsignificant trends towards decreased PSA (-0.46 versus 0.21 ng ml-1 ; P = 0.11), PV (-6.65% versus 3.4%; P = 0.08) and MSHQ scores (-10.2 versus 5.6; P = 0.06). Dutasteride reduces PSA and PV for men on T therapy, but perhaps less so than in men without T therapy"
  • Systematic review evaluating cardiovascular events of the 5-alpha reductase inhibitor - Dutasteride - J Clin Pharm Ther. 2013 Jul 1 - "We did not find consistent evidence of a significant association between dutasteride therapy and the risk of cardiovascular adverse events"
  • A 5-year retrospective analysis of 5α-reductase inhibitors in men with benign prostatic hyperplasia: finasteride has comparable urinary symptom efficacy and prostate volume reduction, but less sexual side effects and breast complications than dutasteride - Int J Clin Pract. 2012 Nov;66(11):1052-5. doi - "The incidence of erectile dysfunction, ejaculatory dysfunction and decreased libido resulting in discontinuation from therapy was significantly (p<0.01) higher in the dutasteride (5.1%, 2.4%, 2.7% respectively) compared with the finasteride (2.1%, 1.8%, 1.4% respectively) group. In addition, the incidence of self-reported breast tenderness and/or enlargement was significantly (p<0.01) greater in the dutasteride (3.5%) compared with the finasteride (1.2%) group. Conclusions: In this retrospective analysis of data from consecutive patients treated at a single clinic, both finasteride and dutasteride were effective therapies for the management of lower urinary tract symptoms. However, dutasteride resulted in significantly more sexual side effects and breast complications than finasteride" - Note:  I'm not sure that makes sense.  The first sentence says "resulting in discontinuation from therapy"
  • Dutasteride/Tamsulosin: in benign prostatic hyperplasia - Drugs Aging. 2012 May 1;29(5):405-19 - "Dutasteride 0.5 mg/day plus tamsulosin 0.4 mg/day improved lower urinary tract symptoms (LUTS) to a significantly greater extent than dutasteride or tamsulosin alone in men with BPH, moderate to severe LUTS and an increased risk of disease progression, according to the results of the randomized, double-blind, multinational CombAT trial. The mean change from baseline in the total International Prostate Symptom Score was significantly greater with dutasteride plus tamsulosin than with dutasteride or tamsulosin alone after 2 years (primary endpoint) and 4 years of therapy. After 4 years' therapy in the CombAT trial, the time to first acute urinary retention or BPH-related surgery (primary endpoint) significantly favoured men with symptomatic BPH who were receiving dutasteride plus tamsulosin versus those receiving tamsulosin alone, with no significant difference between recipients of dutasteride plus tamsulosin and recipients of dutasteride alone. In the CombAT trial, health-related quality of life and treatment satisfaction were improved to a significantly greater extent with dutasteride plus tamsulosin than with dutasteride or tamsulosin alone. Combination therapy with oral dutasteride plus tamsulosin was generally well tolerated in patients with symptomatic BPH in the CombAT trial"
  • Dutasteride Improves Outcomes of Benign Prostatic Hyperplasia When Evaluated for Prostate Cancer Risk Reduction: Secondary Analysis of the REduction by Dutasteride of Prostate Cancer Events (REDUCE) Trial - Urology. 2011 Jul 14 - "During the 4-year study, the International Prostate Symptom Score increased in placebo-treated patients, while dutasteride-treated patients had a stabilized or decreased International Prostate Symptom Score and improved BPH Impact Index and quality of life due to urinary symptom scores across all prostate volume quintiles (including prostate glands smaller than those studied in previous dutasteride trials). 48 months, the incidence of acute urinary retention or BPH-related surgery was significantly less in the dutasteride group (2.5%) than in the placebo group (9%) overall (P < .001) and in each baseline prostate volume quintile (P < .01)"
  • Effect of dutasteride, tamsulosin and the combination on patient-reported quality of life and treatment satisfaction in men with moderate-to-severe benign prostatic hyperplasia: 4-year data from the CombAT study - Int J Clin Pract. 2010 May 7 - "Subjects were randomised to receive 0.5 mg dutasteride, 0.4 mg tamsulosin or the combination once daily for 4 years ... At 4 years, combination therapy resulted in significantly superior improvements from baseline in BII and IPSS Q8 than either monotherapy; these benefits were observed from 3 months onwards compared with dutasteride and from 9 months (BII) or 12 months (IPSS Q8) onwards compared with tamsulosin. Also at 4 years, the PPSM questionnaire showed that a significantly higher proportion of patients was satisfied with, and would request treatment with, combination therapy compared with either monotherapy. Conclusions: Combination therapy (dutasteride plus tamsulosin) provides significantly superior improvements in patient-reported quality of life and treatment satisfaction than either monotherapy at 4 years in men with moderate-to-severe BPH symptoms" - See dutasteride at OffshoreRx1.com.
  • Association of Sexual Dysfunction With Lower Urinary Tract Symptoms of BPH and BPH Medical Therapies: Results From the BPH Registry - Urology. 2009 Jan 21 - "The severity of lower urinary tract symptoms (LUTS) has correlated with erectile dysfunction (ED) and ejaculatory dysfunction (EjD) ... The alpha(1A)-subtype nonsuperselective quinazoline alpha(1)-blockers alfuzosin, doxazosin, and terazosin appeared to be associated with better ejaculatory function than were the alpha(1A)-subtype superselective sulfonamide alpha(1)-blocker tamsulosin, 5alpha-reductase inhibitors, and alpha(1)-blocker plus 5alpha-reductase inhibitor combination therapy"
  • Effect of Dutasteride on Intraprostatic Androgen Levels in Men With Benign Prostatic Hyperplasia or Prostate Cancer - Urology. 2008 Aug 19 - "The results of our study have shown that dutasteride provides near-maximal suppression of both serum and intraprostatic DHT levels in men with benign prostatic hyperplasia or prostate cancer at all points assessed"
  • The Rationale for Inhibiting 5alpha-Reductase Isoenzymes in the Prevention and Treatment of Prostate Cancer - J Urol. 2008 Feb 14 - "The 2 5alpha-reductase inhibitors currently clinically available are finasteride, a type 2 5alpha-reductase inhibitor, and dutasteride, a dual 5alpha-reductase inhibitor. Dual inhibition by dutasteride has been shown to translate into a greater degree and consistency of dihydrotestosterone suppression compared with finasteride. The Prostate Cancer Prevention Trial showed that finasteride significantly decreased the 7-year risk of prostate cancer in men with prostate specific antigen 3.0 ng/ml or less, while the ongoing Reduction by Dutasteride of Prostate Cancer Events study is assessing whether dutasteride decreases the risk of biopsy detectable prostate cancer in men with prostate specific antigen 2.5 to 10 ng/ml and a previous negative biopsy"
  • The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride - J Am Acad Dermatol. 2006 Dec;55(6):1014-23 - "Dutasteride increased target area hair count versus placebo in a dose-dependent fashion and dutasteride 2.5 mg was superior to finasteride at 12 and 24 weeks" - Note:  Dutasteride is Avodart®.  See dutasteride at OffshoreRx1.com or International Antiaging Systems.

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