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Dutasteride: Treatment of Benign Prostate Hyperplasia

Mechanism of Action of Dutasteride

Dutasteride is a selective competitive inhibitor of 5α-reductase type 1 and 2 of the prostate, seminal vesicles and skin. The inhibition lowers the concentration of dihydrotestosterone (DHT) in the prostate. Since DHT causes the androgenic effect in the prostate, the inhibition of 5α-reductase leads to a reduction in prostate volume. Furthermore, dutasteride is used to treat male pattern baldness.

Indications for Dutasteride in Urology

Dutasteride is indicated in lower urinary tract symptoms or bleeding due to benign prostate enlargement. Prostate volume is predictive of success: patients with a prostate volume >30 ml were enroled in the pivotal study.

The consequence of dutasteride treatment is the shrinkage of the prostate, improvement of LUTS and IPSS score, improved urinary flow, risk reduction for urinary retention, gross hematuria or the need for TURP after several years of treatment.

Pharmacokinetics of Dutasteride

Hepatic metabolization. Long life of 3--5 weeks.

Side Effects of Dutasteride

Side effects are comparable to finasteride. Libido loss or erectile dysfunction may be permanently disturbed if taken long-term in some patients (Traish et al, 2011)

Drug Interactions with Dutasteride

No important drug interactions are known.

Contraindications of Dutasteride

• Severe hepatic insufficiency
• Women, pregnancy, children

Dosage of Dutasteride

0,5 mg 1–0–0 p.o.

References

Andriole u.a. 2004 ANDRIOLE, G. ; BRUCHOVSKY, N. ; CHUNG, L. W. ; MATSUMOTO, A. M. ; RITTMASTER, R. ; ROEHRBORN, C. ; RUSSELL, D. ; TINDALL, D.:

Dihydrotestosterone and the prostate: the scientific rationale for 5alpha-reductase inhibitors in the treatment of benign prostatic hyperplasia.
In: J Urol
172 (2004), Nr. 4 Pt 1, S. 1399–403

Chapple 2004 CHAPPLE, C. R.:

Pharmacological therapy of benign prostatic hyperplasia/lower urinary tract symptoms: an overview for the practising clinician.
In: BJU Int
94 (2004), Nr. 5, S. 738–44

  Deutsche Version: Dutasterid