Dutasteride is a prescription medication specifically formulated for the treatment of symptomatic benign prostatic hyperplasia (BPH) in men with an enlarged prostate. As a potent 5-alpha-reductase inhibitor, it works by reducing the production of dihydrotestosterone (DHT), a hormone that contributes to prostate growth. This action leads to a decrease in prostate size, improvement in urinary flow, and reduction in the risk of acute urinary retention and the need for prostate-related surgery. It is not indicated for use in women or children, and requires careful medical supervision to monitor efficacy and potential side effects.

Features

• Contains dutasteride as the active ingredient
• Available in 0.5 mg soft gelatin capsules
• Dual inhibitor of both type 1 and type 2 isoforms of 5-alpha-reductase
• Significantly reduces serum dihydrotestosterone (DHT) levels by up to 90%
• Once-daily oral administration
• Manufactured under strict pharmaceutical quality control standards

Benefits

• Reduces prostate volume, alleviating pressure on the urethra
• Improves urinary flow and reduces frequency of urination
• Decreases the risk of acute urinary retention episodes
• Lowers the probability of requiring BPH-related surgery
• Provides long-term management of BPH symptoms
• Enhances overall quality of life through improved urinary control

Common use

Dutasteride is primarily prescribed for the treatment of symptomatic benign prostatic hyperplasia in adult men. It is used to improve urinary symptoms, reduce the risk of acute urinary retention, and decrease the need for surgical intervention related to BPH. Some healthcare providers may also prescribe dutasteride off-label for androgenetic alopecia (male pattern hair loss), though this use is not FDA-approved for the medication. Treatment is typically long-term, as symptoms may return upon discontinuation.

Dosage and direction

The recommended dosage is one 0.5 mg capsule taken orally once daily, with or without food. The capsule should be swallowed whole and not crushed or chewed. Patients should be advised to take dutasteride at approximately the same time each day to maintain consistent drug levels. Clinical improvement may be observed as early as 3-6 months after initiation of therapy, though maximum therapeutic benefit typically requires 6-12 months of continuous treatment. Dosage adjustment is not necessary for elderly patients or those with renal impairment.

Precautions

Patients should be informed that dutasteride is contraindicated in women and children. Men taking dutasteride should not donate blood until at least 6 months after their last dose to prevent potential exposure to pregnant transfusion recipients. Regular digital rectal examinations (DRE) and prostate-specific antigen (PSA) testing are recommended as dutasteride reduces PSA levels by approximately 50% after 6 months of treatment. Healthcare providers should adjust PSA values accordingly when monitoring for prostate cancer. Patients should be counseled about the potential sexual side effects before initiating therapy.

Contraindications

Dutasteride is contraindicated in the following populations: women who are or may become pregnant due to risk of fetal harm, children, patients with hypersensitivity to dutasteride or any component of the formulation, and patients with severe hepatic impairment. The medication is also contraindicated in patients with a history of allergic reactions to other 5-alpha-reductase inhibitors. Women who are breastfeeding should avoid handling crushed or broken capsules due to potential absorption through the skin.

Possible side effects

The most commonly reported side effects include:

• Decreased libido (3-4%)
• Erectile dysfunction (5-8%)
• Ejaculation disorders (1-2%)
• Gynecomastia (breast enlargement and tenderness) (1-2%)
• Dizziness (1%)
• Allergic reactions including rash, itching, and swelling

Less common but serious side effects may include depression, male breast cancer (rare), and elevated cardiac failure risk in certain populations. Most sexual side effects are reversible upon discontinuation, though some cases of persistent sexual dysfunction have been reported post-marketing.

Drug interaction

Dutasteride is primarily metabolized by CYP3A4 enzymes. Concomitant use with potent CYP3A4 inhibitors such as ritonavir, ketoconazole, verapamil, diltiazem, cimetidine, or erythromycin may increase dutasteride exposure. However, dosage adjustment is generally not recommended. No clinically significant interactions have been observed with tamsulosin, warfarin, digoxin, or cholestyramine. Patients should inform their healthcare provider about all medications, including prescription drugs, over-the-counter medications, and herbal supplements.

Missed dose

If a dose is missed, patients should take it as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped and the regular dosing schedule resumed. Patients should not take a double dose to make up for a missed one. Consistent daily dosing is important for maintaining therapeutic effect, but occasional missed doses are unlikely to significantly affect long-term treatment outcomes.

Overdose

No specific antidote for dutasteride overdose exists. Single doses up to 40 mg have been administered without significant adverse effects. In case of suspected overdose, symptomatic and supportive treatment should be initiated. Since dutasteride is highly protein-bound, dialysis is unlikely to be beneficial. Medical attention should be sought immediately if an overdose is suspected, though the medication’s safety profile suggests serious consequences are unlikely with accidental overdose.

Storage

Store at room temperature between 20°C to 25°C (68°F to 77°F), with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep the medication in its original container, tightly closed, and protected from light and moisture. Do not store in bathroom cabinets where humidity levels may fluctuate. Keep out of reach of children and pets. Properly discard any expired or unused medication through medication take-back programs or according to FDA guidelines.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. Dutasteride is a prescription medication that should only be used under the supervision of a qualified healthcare professional. Individual results may vary, and not all patients will experience the same benefits or side effects. Patients should consult with their healthcare provider for personalized medical advice, diagnosis, and treatment recommendations. Never initiate or discontinue medication without professional medical guidance.

Reviews

Clinical studies demonstrate that dutasteride significantly improves BPH symptoms in approximately 70% of patients after 12 months of treatment. The CombAT study showed combination therapy with dutasteride and tamsulosin provided superior symptom improvement compared to monotherapy. Patient-reported outcomes indicate improved quality of life scores related to urinary symptoms. Some patients report satisfaction with reduced urinary frequency and improved flow, while others note concerns about sexual side effects. Long-term data from the REDUCE trial confirms durable efficacy with maintained reduction in prostate volume and improved urinary symptoms over 4 years of treatment.