Avodart (Dutasteride)

This medication is used in men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH). It works by reducing the size of the enlarged prostate. This helps to relieve symptoms of BPH such as difficulty in beginning the flow of urine, weak stream, and the need to urinate frequently or urgently (including during the middle of the night). It may also reduce the need for surgery to treat BPH.

Garvan

Pharmacist - M.B.A. (Public Health) D.I.C.

Avodart (Dutasteride)

What is it used for? Enlarged prostate gland (…

Garvan J. Lynch
MBA (Public Health)

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What is it used for?

  • Enlarged prostate gland (benign prostatic hyperplasia).
  • Avodart is used to relieve moderate to severe symptoms of BPH and to reduce the risk of developing a complete inability to pass urine (acute urinary retention) that may require surgery.

How does it work?

  • Avodart capsules contain the active ingredient dutasteride, which is a type of medicine called a 5-alpha reductase inhibitor.
  • Dutasteride works by inhibiting the action of a substance in the body called 5-alpha reductase. 5-alpha reductase is an enzyme that is responsible for converting the male hormone testosterone into a more active form called dihydrotestosterone (DHT).
  • The enlargement of the prostate gland, (known medically as benign prostatic hyperplasia), which often occurs in men with advancing age, is dependent upon testosterone being converted to DHT within the prostate gland. In the absence of DHT the prostate gland shrinks. By decreasing the amount of testosterone that is converted into DHT, dutasteride therefore helps to shrink the prostate gland.
  • The prostate gland is found only in men and lies at the top of the tube connecting the bladder to the outside (urethra). Enlargement of the prostate causes it to press on the urethra and bladder and can cause urinary symptoms such as difficulty passing urine and increased need to urinate, particularly at night. By shrinking the prostate, dutasteride relieves the pressure on the bladder and urethra. This allows urine to flow freely past the prostate and relieves the urinary symptoms associated with this condition.

How do I take it?

  • One Avodart capsule should be taken once a day, preferably at the same time each day. The capsule can be taken either with or without food.
  • The capsules should be swallowed whole and not chewed or opened, because the contents of the capsule may irritate the lining of the mouth and throat.
  • If you forget to take a dose don't worry, just leave out the missed dose and take your next dose as usual when it is due. Do not take a double dose to make up for a missed dose.
  • You may see an improvement in your symptoms soon after starting treatment with this medicine, but most men will need to take it for at least six months to see if it helps. Keep taking it until your doctor tells you to stop.

Warning

  • This medicine does not cause prostate cancer, but prostate cancer can be another cause of an enlarged prostate gland. For this reason, tests for prostate cancer should be carried out before you start treatment with this medicine, and at regular intervals thereafter. One test that can be carried out is a digital rectal examination (DRE), to check if the prostate gland is enlarged. The other is to measure the level of prostate specific antigen (PSA) in the blood. An increase in the PSA levels may mean that the prostate gland is enlarged. This medicine can decrease the amount of PSA in the blood by about 50 per cent after six months treatment, even in men who have prostate cancer. Your doctor will take this into account when interpreting the results of any blood tests.
  • This medicine has been reported to affect semen characteristics (reduction in sperm count, semen volume, and sperm motility) in healthy men. This means that there is a possibility that it may reduce your fertility and ability to father a child. If this is a concern to you, you should discuss fertility with your doctor before starting treatment.
  • While you are taking this medicine you should use a condom during sex if your sexual partner is pregnant or could become pregnant. This is because the active ingredient of this medicine passes into semen and could harm the development of a male baby.
  • Men taking this medicine should not donate blood link during treatment and for at least six months after stopping treatment with this medicine. This is because if a pregnant woman was given the blood the medicine could harm the development of a male baby.
  • Dutasteride can be absorbed through the skin and for this reason women, children and adolescents should avoid contact with any capsules of this medicine that are leaking. If contact is made with leaking capsules, the contact area should be washed immediately with soap and water.
  • A few cases of male breast cancer have been reported with this medicine. It is currently not clear if these were related to use of the medicine. However, it is important to tell your doctor if you notice any changes in your breast tissue during treatment, for example lumps, pain or nipple discharge.

Use with caution in

  • Men with mild to moderately decreased liver function.
  • Not to be used in
  • Women.
  • Children or adolescents under 18 years of age.
  • Men who are allergic to other 5-alpha reductase inhibitors, eg finasteride.
  • Men who are allergic to soya or peanuts.
  • Men with severely decreased liver function.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

  • This medicine may pass into semen. For this reason, while you are taking this medicine you should use a barrier form of contraception such as a condom during sex if your partner is or may be pregnant, to avoid any possible risks to a developing male baby.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

  • Difficulty achieving or maintaining an erection (impotence).
  • Decreased sex drive.
  • Ejaculation disorders, such as decreased amount of semen produced or decreased sperm count.
  • Breast enlargement or tenderness.
  • Allergic reactions such as rash, itching or localised swelling.
  • Dizziness.
  • Hair loss (primarily body hair) or increased hair growth.
  • Swelling or pain in the testicles.
  • Heart failure.
  • Depressed mood.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

The following medicines may increase the level of dutasteride in the blood by interfering with its breakdown by the body:

  • diltiazem
  • indinavir
  • itraconazole
  • ketoconazole taken by mouth
  • nefazodone
  • ritonavir
  • verapamil

Let your doctor know if you experience any new or increased side effects if you are taking any of these medicines in combination with dutasteride. Your doctor may ask you to take the dutasteride less frequently to resolve this.

There may be a slightly increased risk of heart failure if you take this medicine in combination with tamsulosin.

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