Dutasteride

About Dutasteride

Dutasteride blocks both forms of the enzyme that turns testosterone into dihydrotestosterone (DHT), the hormone that drives prostate growth. Avodart is labeled for symptomatic BPH in men with an enlarged prostate, to improve symptoms and lower the risk of acute urinary retention and of BPH-related surgery, and, together with the alpha-blocker tamsulosin, to treat symptomatic BPH. The dose is one 0.5 mg capsule a day, with or without food; MedlinePlus says symptoms may start to improve after 3 months and the full benefit can take 6 months or longer. Jalyn and its generics hold 0.5 mg dutasteride and 0.4 mg tamsulosin, taken once a day about 30 minutes after the same meal, and are not combined with another alpha-blocker. None of these products is approved to prevent prostate cancer or labeled for women or children. Dutasteride is not FDA-approved for hair loss; any such use is off-label, and the prescriber decides.

There is no boxed warning. Dutasteride must not be used in pregnancy or after a clinically significant allergic reaction, such as a serious skin reaction or angioedema, to it or another 5-alpha reductase inhibitor; for Jalyn, that includes tamsulosin. The label says 5-alpha reductase inhibitors may increase the risk of high-grade prostate cancer, and conditions with similar symptoms are considered first. Dutasteride lowers PSA, the prostate cancer screening test: a new baseline is set at least 3 months after starting, a single result after 3 months or more is doubled before it is compared with men not taking it, and any confirmed rise from the low point reached on treatment is evaluated. Side effects include erectile dysfunction, decreased libido, ejaculation problems and breast enlargement or tenderness, and the sexual side effects may continue after stopping (the label calls dutasteride’s role in this unknown). Reports since approval include allergic reactions, depressed mood, testicular pain and swelling, and male breast cancer. Jalyn also carries tamsulosin’s warnings, including dizziness or fainting on standing, priapism and floppy iris syndrome during cataract or glaucoma surgery.

The capsules are swallowed whole, never chewed or opened, because the contents can irritate the mouth and throat. Dutasteride can be absorbed through the skin, so women who are or may be pregnant should not handle the capsules, and skin that touches a leaking capsule is washed right away with soap and water. Men should not donate blood until at least 6 months after the last dose, so that a pregnant woman cannot receive the drug through a transfusion. In a study, dutasteride lowered sperm count, semen volume and sperm motility, and the drop in sperm count had not reversed 24 weeks after stopping; what that means for an individual man’s fertility is unknown.

Taking Dutasteride

How to take it

One capsule once a day. Avodart can be taken with or without food; take Jalyn about 30 minutes after the same meal each day. Swallow capsules whole; do not chew, crush or open them. Keep taking it even if you feel well.

If you miss a dose

If you remember the same day, take the missed dose then; if not until the next day, skip it and carry on as usual. Never take two doses in one day. A missed Jalyn capsule can be taken later that day, 30 minutes after a meal; after several missed days, ask the prescriber before restarting.

Storage

At room temperature in the container it came in, tightly closed, out of reach of children. High heat can deform or discolor the capsules; do not use any that are deformed, discolored or leaking.

Interactions to know about

Long-term use with strong CYP3A4 inhibitors such as ritonavir calls for caution, since they raise dutasteride levels. Jalyn adds tamsulosin’s interactions: strong CYP3A4 inhibitors such as ketoconazole are not used, other alpha-blockers are not combined, and erectile dysfunction drugs, cimetidine and warfarin call for caution.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Dutasteride differs from pharmacy to pharmacy

Generic dutasteride capsules rated to Avodart come from many makers, so quotes for the same quantity differ by each pharmacy’s fee and markup and by whether dutasteride is on its flat-price generic list. Generic dutasteride and tamsulosin capsules rated to Jalyn come from few makers.

The combination capsule and the two single-ingredient capsules are different products, so a pharmacist fills the one written and cannot switch between them without the prescriber. A prescription that names Avodart or Jalyn and blocks substitution is filled with the brand.

Ways to pay less for Dutasteride without insurance

• Ask for a generic rated to the product prescribed, and check that the prescription does not block substitution.
• Ask whether dutasteride is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Once treatment is settled, ask the prescriber for a ninety-day supply.
• If you take dutasteride with tamsulosin, ask the prescriber whether the combination capsule or two separate capsules would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Dutasteride

1. 1.How long before my urinary symptoms should improve?
2. 2.What should a woman in my home do if she touches a leaking capsule?
3. 3.When can I donate blood after I stop taking it?
4. 4.Should the doctor who orders my PSA test know that I take dutasteride?

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