Brand Name Manufacturers	Avodart Avolve (both by GlaxoSmithKline)
Generic Manufacturers	None
Pharmacology	Dutasteride inhibits the conversion of testosterone to Dihydrotestosterone (DHT). DHT is the androgen primarily responsible for the initial development and subsequent enlargement of the prostate gland. Testosterone is converted to DHT by the enzyme 5 -alpha reductase (5-AR), which exists as two forms, Type 1 and Type 2. The Type 2 form is primarily active in the reproductive tissues while the Type 1 is also responsible for testosterone conversion in the skin and liver. Dutasteride is a competitive and specific inhibitor of both Type 1 and Type 2 5-AR enzymes. Dutasteride does not bind to the human androgen receptor.
Delivery	0.5mg dutasteride per soft gelatin capsule.
Typical dosage	Post-op .5mg/day oral tablets Pre-op 2.5 mg - 5mg/day oral tablets (See Notes below)
Availability	Approved by U.S. FDA
Indications	Benign prostate enlargement
Contraindications	Hypersensitivity or allergic reactions to any component of the product. Pregnant women (or those who may become pregnant) should not come in contact with the drug, it is easily absorbed through the skin. Children should not use Dutasteride. Men using Dutasteride should not donate blood until at least 6 months after the medication was last used for fear of possible administration of dutasteride tainted blood to pregnant female transfusion patient. Men with liver problems should not use Dutasteride. Caution if used with chronic CYP3A4 enzyme inhibitors (e.g., Ritonavir).
Adverse reactions	Abnormal ejaculation; decreased interest in sexual intercourse; decreased sexual performance or desire; impotence; inability to have or keep an erection; loss in sexual ability, desire, drive, or performance; swelling of the breasts or breast soreness. Amount of semen in ejaculate may be decreased in some patients. This decrease does not interfere with normal sexual function.
Comments	Clinical studies proved Dutasteride is far more effective at inhibiting the formation of DHT than Finasteride, partly due to the fact Finasteride does not block Type 1 5-AR enzyme activity. Dutasteride's level of effectiveness at blocking Type 1 and Type 2 5-AR was not compared to that of Natural Progesterone. Following administration of a single 0.5mg dose of a soft gelatin capsule, time to peak serum concentrations of Dutasteride occurs within 2 to 3 hours. Absolute bioavailability is approximately 60% (range 40% to 94%). When the drug is administered with food, the maximum serum concentrations were reduced by 10% to 15%. This reduction is of no clinical significance. After 1 and 2 weeks of daily dosing with Dutasteride 0.5 mg, median serum DHT concentrations were reduced by 85% and 90%, respectively. The median increase in serum testosterone was 19% at both 1 and 2 years but remained within the physiologic range. Effect on most hormones was not significant. Dutasteride's effect on endogenous progesterone levels was not reported. Dutasteride's effectiveness has not been tested when used in conjunction with other common HRT medications and may be lower than if used as a monotherapy. Pre-operative and Post-operative dosages listed above are just guesswork, there is little, if any, experience with this drug in the treatment of Transsexual patients.
Additional Info:	Avodart Prescribing Information (PDF file on this site)

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