Avodart

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In 2002, the FDA approved Avodart (dutasteride 0.5mg) for the treatment of prostate enlargement in men (the medical term is symptomatic benign prostatic hyperplasia or BPH). Dutasteride is not approved for the treatment of male pattern hair loss.
Like finasteride (the active ingredient in Propecia), avodart is an inhibitor of the enzyme 5 alpha-reductase responsible for the conversion of testosterone to DHT (dihydrotestosterone). However, unlike finasteride, which only inhibits the Type I form of the enzyme, dutasteride inhibits both the Type I and Type II forms of the 5 alpha-reductase enzyme. This dual effect makes the drug more potent but also increases the incidence of adverse reactions.The Type II form of the enzyme is found predominantly in the hair follicle [buy avodart]. The Type I form of the enzyme has been found in the scalp and sebaceous glands, but its exact role in hair growth has not been determined.

Effects on Hair Growth

Dutasteride 0.5mg/day decreases serum DHT 91% and scalp DHT 54%. Finasteride 5mg/day decreases serum DHT 71% and scalp DHT 38%. Based on these results, dutasteride should be significantly more effective in the treatment of androgenetic alopecia than finasteride. However, since the Type I form of the 5 alpha-reductase that dutasteride blocks is not present in significant quantities in the hair follicle, these effects may not be as significant as one might expect [buy avodart]. The increased efficacy of Avodart is felt to be due, in part, to its effects on lowering serum DHT.
A study by Olsen et al. published in the Journal of the American Academy of Dermatology in 2006 has showed the benefits of dutasteride over finasteride in a scientifically rigorous, placebo-controlled study.

Side Effects Of Avodart

Dutasteride was investigated in controlled multi-center studies involving 4,325 men aged 50 and above with prostate enlargement. Drug-related side effects during the first six months were as follows: impotence (4.7 percent vs. 1.7 percent for placebo), decreased libido (3 percent vs. 1.4 percent), breast tenderness and breast enlargement (gynecomastia; 0.5 percent vs. 0.2 percent) and ejaculation disorders (1.4 percent vs. 0.5 percent).The incidence of most drug-related sexual adverse events decreased with duration of treatment. The incidence of drug-related breast tenderness and breast enlargement remained constant over the treatment period [buy avodart]. Ejaculate volume may be decreased in some patients with continued treatment. This decrease did not appear to interfere with normal sexual function.

Effects on PSA

Avodart will reduce the amount of PSA measured in the blood and this must be taken into account when PSA is used in the detection of prostate cancer. Even though both finasteride and dutasteride were developed to combat benign prostatic hyperplasia by reducing DHT in prostate tissue, some scientists question the wisdom of using these 5-alpha reductase inhibitors in younger men who have no problem with their prostates. A research chemist [buy avodart], Patrick Arnold, says “Evidence is mounting that the existence of a high estrogen/androgen ratio – a condition common in older men – is highly correlated with the development of benign prostatic hyperplasia.”[citation needed] However, in apparent contradiction, individuals with 5-alpha-reductase deficiency (and thus a similar hormonal profile to users of DHT inhibitors) do not experience BPH.
Avodart does work for hair loss. Dihydrotestosterone is the main molecule responsible for androgenic alopecia or hair loss. Finasteride, which reduces transformation of testosterone into dihydrotestosterone (DHT) and decreases dihydrotestosterone activity, is approved for treatment of androgenic hair loss in men. In one case study, a 46-year-old woman with androgenic alopecia, non-responsive to minoxidil, who initially benefited from finasteride, was given another 5-reductase inhibitor, Avodart. Clinical evaluation and trichogram were applied for assessment of Avodart efficacy in this patient. Additionally, mean hair diameter was monitored by means of computer dermoscopy. After 6 months of therapy, significant improvement was observed and after 9 months the clinical diagnosis of androgenic alopecia could no longer be made in this patient. Avodard is helpful for hair loss. Avodart dosage for hair loss may be less that the dosage required to treat prostate enlargement. For more information on baldness [buy avodart].I read with interest your articles on the potential side effects of Avodart and found it disturbing that some of the Avodart side effects such as musculoskeletal pain were not mentioned on the official Avodart website. On another web site, almost 10% of posters related anecdotes about experiencing unusual pain after taking Avodart. My father is an otherwise healthy 84 y/o Caucasian male. He began taking Avodart for BPH approximately 18 months ago. About 4 months ago he began complaining of joint pain and stiffness, especially in his shoulders and knees, which was more severe at night and upon awakening. He also developed a shortened gait and had some difficulty in walking normally [buy avodart]. He frequently required morning pain relief, which he obtained by taking naproxen or Tylenol, one to two tablets per day. He visited his primary care physician who made an initial diagnosis of arthritis, however, later x-ray imaging of the shoulders showed no significant degeneration or other changes consistent with arthritis, and there is no family hx of arthritis. Approximately one month ago he received cortisone injections in both shoulders, which resulted in some significant pain relief lasting for about 10 days. Additional changes in his body habitus which I observed recently include some possible generalized muscle atrophy and an increased resting heart rate. Just 6 months ago he was much more vigorous and more agile than many 60 year olds. About one week ago (August 06) he consulted with his urologist and was instructed to discontinue taking Avodart for 30 days, although the urologist was unaware that musculoskeletal pain is a potential Avodart side effect. Since that time my father has reported some slight improvement, with reduced joint pain, and he has required less frequent oral pain medication. He takes no other prescription medications except Timoptic (ophthalmic) for glaucoma and is otherwise healthy [buy avodart]. He has never had his testosterone levels checked. I am concerned that if his testosterone levels are low and given that conversion to the more androgenic DHT form is blocked by the Avodart, he may be at increased risk for osteoporosis and other side effects of low testosterone levels. Can you provide any recommendations on how to proceed in evaluating and treating him, which he could then discuss with his primary care physician and his urologist?

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