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Avodart, medically known as Dutasteride, is popularly used for effective treatment of benign prostate hypertrophy in men, i.e. men with enlarged prostate. Marketed by GSK, this 5-alpha-reductase inhibitor creates obstacles in the action of the 5-alpha-reductase enzymes that transforms testosterone into dihydrotestosterone (DHT). Unlike finasteride that blocks only one form of 5-alpha-reductase, Avodart (Dutasteride) stamps down both isoforms of 5-alpha-reductase [Type 1 and Type 2]. In addition, Avodart can also help in enhancing urinary flow and decreasing the chances of carcinoma prostate.
What is Benign Prostate Hypertrophy?
Benign prostate hypertrophy is a condition of benign enlargement of prostate mostly found in middle aged men and elder men. There is abnormal increase in the number of prostatic stromal cells and epithelial cells leading to the formation of large nodules in the pre-urethral area of the prostate. Any further increase in their sizes can block the urethral canal completely or partially, thereby resulting in the obstruction of urine flow. Several problems can develop as a result of this, such as:
- Urinary hesitancy
- Frequent urination
- Increased risk of urinary tract infections due to stasis of bacteria in the bladder residue
- Incomplete voiding
- Post-urination dribble
- Nocturia – Need to urinate during the night
- Dysuria - Painful urination
- Weak urinary stream
- Urinary Retention of acute or chronic nature in which there is gradual increase in the residual urinary volume, distending the bladder
- Obstructive uropathy resulting in renal failure
- Urinary bladder stone formation
There is a metabolite of testosterone, known as Dihydrotestosterone that plays a vital role in the growth of prostate. Dihydrotestosterone is synthesized under the action of the enzyme 5-alpha-reductase, type 2 in the prostate from the circularizing testosterone. Since this enzyme is placed mainly in the stromal cells, these cells are the chief location for the synthesis of dihydrotestosterone. Although all men demonstrate prostate hypertrophy as they grow old, particularly after 70 years, the incidence of symptomatic prostatic hypertrophy is detected more in men leading a western lifestyle than in men from countryside areas. Benign hypertrophy of prostate is related with increased levels of serum Prostate Specific Antigen [PSA] which is an indicator for carcinoma prostate. However, it is not looked at to be a pre-malignant condition. This condition is diagnosed primarily by rectal examination and by ultrasonography.
Indications & Dosage
Monotherapy is a symptomatic treatment of benign prostatic hyperplasia in men having enlarged prostate. It works by improving symptoms, decreasing the risk of acute retention of urine and lowering the risk of benign prostatic hyperplasia related surgery.
Avodart along with tamsulosin is indicated for the treatment of symptomatic BPH in men with an enlarged prostate. As it is mentioned earlier, Avodart (Dutasteride) treats urinary symptoms of enlarging prostate, reduces the chances of acute urinary retention and prostate surgery. As far as dosage is concerned, Avodart can be taken in capsule form of 0.5mg each on a daily basis for monotherapy. In case of monotherapy along with alpha blocker, the daily recommended dose is Avodart 0.5mg once and Tamsulosin 0.4mg once.
Side Effects
Taking Avodart (Dutasteride) can lead to certain side effects, both in case of monotherapy and in combination with alpha blocker tamsulosin. Patients on monotherapy usually experience sexual adverse reactions such as impotence, decreased libido and ejaculatory defects. Breast disorders like breast enlargement and tenderness have been reported too.
Similar side effects have been found in combination with alpha blocker tamsulosin also. Patients can feel dizziness along with hypersensitivity reactions like uritacaria, rash, pruritis, angioneurotic edema, etc. However, long term treatment with Avodart up to 4 years has not witnessed any such side effects.
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