Clinical trials, sponsored primarily by the manufacturer, have shown Avodart to be a treatment for prostate enlargement and similar to finasteride ( Proscar ). Further studies are needed to gain a clearer understanding of any clinically significant differences between Avodart and finasteride. I am not aware of studies comparing Avodart to saw palmetto or other herbs for the treatment of prostate enlargement or hair growth. However my best understanding is that Avodart is significantly more effective for the treatment of hair loss than any natural supplement that I am aware of. For information on natural supplements and hair loss.


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Avodart for Prostate enlargement
According to the manufacturer, Avodart is indicated for those with enlarging prostate, sometimes called benign prostatic hyperplasia, or BPH for short. Avodart may shrink the prostate, improve BPH symptoms, and perhaps lower the chance for problems like surgery on the prostate.

Avodart or Proscar?
Avodart is a dual 5alpha-reductase inhibitor for the treatment of benign prostatic hyperplasia. Avodart differs from finasteride as it inhibits both isoenzymes of 5alpha-reductase and results in near-complete suppression of serum dihydro-testosterone. Similar to finasteride, Avodart reduces serum prostatic specific antigen by approximately 50% at 6 months and total prostate volume by 25% in 2 years. Randomised, placebo-controlled trials conducted over 2 years have shown the efficacy of Avodart in symptomatic relief, and peak urinary flow rate, and reduction of acute urinary retention events and the need for surgery. The main Avodart side effects are erectile dysfunction, decreased libido, gynacomastia and ejaculation disorders. Avodart has been shown to possess tumor regression properties in vitro and its role in chemoprevention of prostate cancer is being evaluated in the ongoing Reduction by Dutasteride of Prostate Cancer Events (REDUCE) trial.

Dutasteride Avodart side effects
Possible side effects with Avodart are impotence (trouble getting or keeping an erection), a decrease in libido (sex drive), swelling or tenderness of the breast, and a decrease in the amount of semen released during sex. Avodart side effects could also include allergic reactions such as rash, itching, hives, and swelling of the lips or face. Another potential Avodart side effect is muscle aches. We have had 2 emails of this potential Avodart side effect and we can't be sure the drug is responsible until we receive more information. See the bottom of this page for a fuller description of this Avodart side effect.
     Lower urinary tract symptoms (LUTS) and male sexual dysfunction are highly prevalent in aging men, and are strongly linked. Various treatment strategies for benign prostatic hyperplasia may affect sexuality, with differences between drug classes and between drugs within a same class. The 5alpha-reductase inhibitors, finasteride and Avodart are associated with a greater side effect risk of erectile dysfunction, ejaculatory dysfunction (EjD) and decreased libido than is placebo. The Avodart side effect regarding sexual health is a concern for many men who are medicated with this drug. Passion Rx, Prostate Power Rx, or natural sex herbs could potentially be helpful in some men in reversing some of these Avodart related sexual side effects.

Avodart and hair loss
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.

5 Alpha Reductase and Avodart
Both finasteride and Avodart are slow, time-dependent inhibitors of steroid 5 alpha-reductase type II. Overall, Avodart is a more efficient steroid 5 alpha-reductase inhibitor than finasteride.

Prostate Medicine - Prostate Drugs
Several drugs are currently used as prostate medicine, the most commonly used is Proscar (finasteride) for prostate enlargement. Avodart - Dutasteride manufactured by GlaxoSmithKline; Dutas - Generic Dutasteride manufactured by Dr. Reddy's; Fincar - Generic Proscar manufactured by Cipla; Flomax - Tamsulosin Hydrochloride manufactured by Boehringer Ingelheim; Proscar - Finasteride (5mg) manufactured by Merck; Calutide - Generic Casodex manufactured by Cipla; Cytomid - Generic Flutamide manufactured by Cipla.

Avodart Research Update
Clinical Usefulness of Serum Prostate Specific Antigen for the Detection of Prostate Cancer is Preserved in Men Receiving the Dual 5alpha-Reductase Inhibitor Avodart.
J Urol. 2006 May;175(5):1657-62. Andriole GL, Marberger M, Roehrborn CG.
Division of Urologic Surgery, Washington University, St. Louis, Missouri.
We determined whether the decrease in serum PSA seen with 5alpha-reductase inhibitors affects the clinical usefulness of PSA for prostate cancer screening using data from 2 dutasteride Avodart benign prostatic hyperplasia studies. MATERIALS AND METHODS: A total of 2,802 men 50 years or older with a clinical diagnosis of benign prostatic hyperplasia, no history of prostate cancer, PSA 1.5 to 10 ng/ml, prostate volume 30 cc or greater, an American Urological Association symptom score of 12 or greater and peak urinary flow rate 15 ml per second or less were randomized to 0.5 mg Avodart dutasteride daily or matching placebo for 24 months. CONCLUSIONS: A doubling factor is effective for maintaining the sensitivity and specificity of PSA for prostate cancer detection in men on Avodart. Increases in serum PSA in men receiving Avodart should be considered suspicious and serial PSA measurements should be used to evaluate changes from nadir.

Avodart Questions
Q. I want to buy Avodart, is there a generic Avodart on the market? Is Propecia good for the prostate, too?
     A. I am not aware of a generic form of Avodart, I think the patent on Avodart still has many years to go. As to Propecia, it contains one mg of finasteride and may work well for those who have a mild to moderate case of BPH rather than taking Proscar which has 5 mg of finasteride.

Q. You made a comment on one of your website articles that you were not aware of a generic form of Avodart. Actually, there is out of India, and I have used their generic finasteride (Fincar) for some time, and it is actually quite good.
     A. Avodart is a different medicine, the generic name is dutasteride, not the same as finasteride. Generic Avodart from generic drug makers is not available since the patent on Avodart has many more years to go.

Q. Is saw palmetto a good alternative to Avodart for hair loss? What about prostate enlargement?
     A. I have not seen any studies comparing saw palmetto to Avodart, so it is difficult to say. A comprehensive prostate formula with several herbs, such as Prostate Power Rx, may be a good initial option in mild to moderate cases of BPH. I don't believe saw palmetto by itself is effective for hair loss.

Q. Where can I buy Avodart ?
     A. You can buy Avodart at a pharmacy with a doctor's prescription. Avodart is not sold over the counter.

Q. I sent you, under separate email, a “Live Science” article regarding a study that indicates that men with low testosterone die sooner. I am an “over 50” male with an enlarged prostate and relatively high PSA reading which has proven to be non-cancerous. I am taking Avodart which has apparently shrunk my prostate to a reasonable size and the symptoms of frequent urination and difficulty in starting urination have gone away. The side effects seem to be a decreased semen production, but my sex drive is still there (not like when I was 25 though). If the article regarding low testosterone is correct, and if my assumption about Avodart is correct, that it lowers testosterone levels, could Avodart possibly shorten my life span? I wrote to Avodart and they told me to consult with my doctor. I then sent them another email saying that I wanted to take the question off of the personal level and ask it as a general question about the product line and, so far, no answer.
     A. As far as we know, Avodart blocks the conversion of testosterone to DHT, rather than decreasing testosterone levels. The long term health consequences of regular Avodart use, and reduction of DHT levels, are not known. Just to be on the safe side, it is best to use Avodart in as low a dosage as possible and perhaps taking occasional breaks from use. This has to be done in agreement with your prescribing doctor.

Q. 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 (GlaxoSmithKline) 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. 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. 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? Thank you.
     A. The information you provide about possible Avodart side effects regarding joint pain is interesting and the first we have had reported. We appreciate your email, but we are not in a position to offer individual advice, but his doctor is welcome to read the info on prostate health on our website.

Q. I am a 65 year old male with BPH. My urologist in Winston Salem) recently prescribed 0.5 mg Avodart daily. I have only noticed one continued Avodart side effect when taking the drug. One hour after injesting the Avodart, my lower body begins to experience a strong aching effect that is most noticable in my groin area. This aching increases and eventually extends to the lower limbs and continues for a period of approximately 12 hours, at which time it begins to gradually decrease in intensity. These effects restart again after taking another dose of Avodart. I need to reduce the size of my prostate, but this aching is definitely affecting my body and my general wellness. Can you tell me of another similar drug that is comptible to Avodart or if the drug is avaliable in lower doses.
     A. We have not heard of this potential Avodart side effect before. As far as we know, Avodart is only available in 0.5 mg dosage. Another option is to try Propecia or Proscar since they also are helpful for enlarged prostate. You may also consider Prostate Power Rx which may be helpful by itself, or may reduce the dosage required of finasteride, the active ingredient in Propecia or Proscar. Discuss with your doctor before making any changes.

Q. It was with great interest that I read the questions about muscle / skeletal pain experienced after taking Avodart. My 83 year old father was being treated for recurring urinary tract infections and an enlarged prostate. He had been taking Flomax since June without problem. In latter Sept., his urologist prescribed Avodart in addition to the Flomax. For the past two weeks dad has been experiencing excrutiating pain from the shoulders to his calves- particularly at night. This is a man who rarely uses medication during post-operative periods and he has been beside himself in pain. He has found some relief (but not enough for sleep) from Darvocet. Last week my brother was helping him keep track of his medications, and somehow Avodart was not included. On Sunday and Monday of this week Dad had little to no pain. I realized he had not been taking Avodart and got him back on it yesterday (Tuesday)- and last night the pain was back with a vengeance and it continued today after he again took the Avodart daily dose. I searched the Avodart website and saw no mention of muscle or skeletal pain, and yet when I read one of the comments about the man with the 84 year old father, the experience seemed cloned. It seems to me that there must be a correlation.

Avodart - Dutasteride - is a 5alpha-reductase inhibitor that inhibits both types 1 and 2 isozymes of 5alpha-reductase, the enzyme responsible for converting testosterone to dihydrotestosterone in the prostate and other tissues. Dihydrotestosterone is the primary cause of prostate growth and has been proven to play a key role in the development and progression of benign prostatic hyperplasia. Avodart has been investigated in three multicenter studies involving 4325 men aged 50 years and above with benign prostatic hyperplasia. Data from these two-year, placebo-controlled studies demonstrated that Avodart 0.5 mg once daily reduced the risk of both acute urinary retention and the need for benign prostatic hyperplasia-related surgical intervention, improved benign prostatic hyperplasia-related symptoms, decreased prostate volume and increased maximum urinary flow rates.

Q. Is it okay to take Avodart one day and Prostate Power Rx the next? I get Avodart side effects when I use it daily but it does help my prostate symptoms.
   A. Herbs are not as potent as drugs. One option, if your doctor agrees, is to alternate every other day taking Avodart one day and prostate power the next, or something similar to this. This way you get herbs that support your prostate while the Avodart helps the symptoms, but have less side effects since a lower amount is being used.

Q. I have developed pain in my leg and knees. I have been on Avodart for six months. I will stop using Avodart temporarily to see if the pain subsides. Will let you know if pain decreases. Thank you for your website.

Q. I've been prescribed Avodart beginning a month ago and have noticed sudden side effect of difficulty in achieving and retaining erections; not a problem previously for me (age 77) thanks to Viagra, gratefully. If i stop taking Avodart (or take it less frequently) will these Avodart side effects disappear, and will testosterone production be restored? I had TURP 15 years ago, last PSA 4.2 ... no difficulty with urination, but retain 2-4oz causing frequency, but not bothersome.
   A. Most side effects from medicines are dose related, therefore theoretically a lower amount or taking Avodart less frequently would cause fewer or less severe Avodart side effects.

Q. Flomax versus Avodart - recently my drs. switched me from flomax to avodart i also take prescription androgel this all seems like a conflict , Flomax i have been on for years i feel no benifit from the avodart, i am switching to weekly injections of testosterone because my levels are so low, what to do.
   A. Sorry but we can't give individual advice except to find a better urologist.

A. What a great site! Your explanation of Avodart is easily the best and most understandable I've seen. You say that generic Avodart is not available. However, I see that can be obtained from this Canadian pharmacy. Any comments?
getcanadiandrugs.com
   A. We looked at the site, it says, "Avodart Dutasteride A prescription is required for this product. BUY DISCOUNT Avodart ONLINE. Item Name Price Qty. 0.5mg (30 pills) $59.99 0.5mg (60 pills) $103.99 0.5mg (90 pills) $154.99 Generic Alternative 0.5mg (100 pills) $114.99. Avodart Description: The generic alternative is not manufactured by the company that makes the brand product.
   We are not sure if we would trust the reliability of the generic Avodart made by another company, however we can't say for sure since we have not tested this " generic avodart " and so we don't know whether it is as good as the brand name Avodart.

Q. Gentlemen: I have just completed reading the above posted Avodart information on my computer. Samples of Avodart medicine were given to me by my urologist. After taking Avodart for 4 days I awoke with both knees in pain. I had difficulty straightening them and after a short walk my leg muscles (all) became sore. Two days after stopping Avodart I felt no discomfort. I am an 88 yr. old vigorous man, walk almost every day at a fast pace, before I took Avodart, and also now, having stopped taking this drug. Manufacturer should include this musculoskeletal pain Avodart side effect in their package brochure.

Q.  Thank you for your news reports on various medications as I do find these very useful. I was especially interested in the information you gave on Avodart. I too have suffered extreme joint pain in each shoulder and am now seeing a doctor just to be treated for that condition! I'm told by him and the doctor who prescribed Avodart that it could not have caused my condition and it's because I'm getting older, I'm 65 now. I do know that Avodart caused this trouble and even though I stopped taking it two months ago I am still suffering a great deal without too much relief. I'm told to take Tylenol Arthritis and that's it. Why is this Avodart drug still on the market?
   A. It is possible that some people are benefiting from Avodart and not getting side effects. Or, perhaps taking a third or half a tablet could also work with fewer side effects. Hopefully the negative reaction your experienced will dissipate with time.

Q. I have been on Avodart for about one year to a year and one half. I have seen an improvement in my condition but my doctor says that Avodart has not worked as well as they would have hoped since they say it hasn't shrunk the prostate in the place where it is needed the most. One day I came in for a urine retention test and they said that it had been the worst they have seen. Six months ago I had retained only 159 cc (?) and this time it was 229. I suggested that perhaps something had change since the last time I was there and I mentioned how i was taking more of klonopin and asked if that could affect urine retentions I was told "no". They said that eventually the bladder would give out and not function. I went to the book store and looked up klonopin and found out that it did cause urine retention. I went to another urologist and had the test done in the morning BEFORE I took the klonopin and the retention was 59cc. This urologist said I was above average in urine flow and not to worry if I stay on the Avodart.

Q. I am an emergency physician that has used Proscar to prevent further hair loss for a number of years. I can tell you that around the time I started to use it I developed muscle spasms and pain to my periscapular region, shoulder, neck but never linked the two. I wrote it off as 'ageing'. These symptoms have progressively worsened over a number of years. I then switched over to Avodart last year. On an empty stomach I did get severe cramps with this medication. Since Avodart has a much higher half life than Proscar I recently decreased its use to only once a week. I now have linked my muscle spasm/pain to its use.....after 3-4 days of not taking it I have no pain, within 1 day of taking Avodart I end up needing to obtain the services of a massage therapist. Hope this information helps. To me it seems very likely that a significant Avodart side effect and even Proscar can be serious muscular pain. Because of this I will probably discontinue my hair loss therapy.

Q. Should Avodart be suspended in a patient who is trying to regenerate muscle after a knee operation?
   A. I don't know for sure what kind of effect Avodart would have after knee surgery and muscle tissue damage or repair, but, as a general rule, it is best to reduce the dosage or stop medications that are not necessary a few days or weeks before and after a surgery.

Q. I am a 68 year old retired toxicologist. I read in your report on Avodart side effects that one individual reported increased pain in the groin area. I can report a similar experience. I started taking Avodart six weeks ago and approximately two weeks after starting I developed a pain in the area of the right groin. This has increased over the past four weeks and starts some two to 3 hours after taking Avodart. The pain maximizes at about 6 hours and after 12 hours begins decreasing. I plan on stopping Avodart to see if the groin pain side effect goes away.
   A. Let us know if the groin pain goes away after you stop the Avodart.
      Q. I have been off Avodart for 5 days and the pain in the groin area has decreased dramatically to the point now it is only noticeable when I think about it. I really do think that Avodart was a significant part, if not the only cause of the groin pain.

Q.  have been taking Avodart for about a year with typical side effects. I have read nothing about how long one can expect to take Avodart medication. Is it a life long thing or can one expect to discontinue its use at some point?
   A. It depends why Avodart is being prescribed. The idea is to use the least dosage that works. One has to benefit the benefit of the medication versus potential Avodart side effects.
      Q.  The prescription for Avodart is for enlarged prostate. My side effects are impotence and night time urination. At least the pain is gone. I just did not want to go on year after year if at some point I should be "cured."
         A. Your physician should periodically assess your prostate size. It is possible that the dosage or frequency of use may be reduced depending on your symptoms.

Q. I have been taking one Avodart capsule and two Flomax capsules altogether, once per day, for over 6 months. I am 58 years old, retired for 4 years, white male, and began taking Flomax the later part of last summer 2007 when I began having more and more trouble urinating. After testing, my doctor started me on Flomax and upon a return visit; I advised I was still having difficulty. He referred me to a urologist who, after testing, diagnosed BPH or me with an enlarged prostate. He prescribed Avodart with the Flomax. After approximately 7 days of taking this medication, I began having muscle and joint pain, and lethargy. However, my problem with urinating was markedly improved. I notified my doctor and he wanted me to continue taking the medication, but said it would be my decision whether to stop or continue. I decided to stop and within approximately 2-3 days, my problem with urination started again, and so I began taking the Avodart with the Flomax again with good results. I also take Lortab (PRN) for two herniated L4 and L5 discs, but I now have to take a Lortab pill when I wake up in the morning to help with the joint and muscle pain, and just walking. Once it takes effect, I am able to get up and go about my normal activities of daily living. However, for the past two weeks I decided to decrease the Flomax by one capsule, since both my doctor and urologist told me to take one Avodart and two Flomax capsules altogether once per day. I decided to see if I could reduce the amount of medication. Since doing this, I have had some trouble with urination again, but am trying to get by on as low dosage as possible. I am only writing because I read on-line of similar problems men have or had experienced when taking this medication and it also has affected my libido and ejaculation, if any, so that is another side effect/problem as well. The only question I have: is there any alternative medications for men with these side effects? I am in otherwise good health and have been working out at the gym almost every day for the past 8-10 years, and have very good muscle tone and strength. I just hate the side effects of this Avodart drug as I know without a doubt the muscle and joint pain and lethargy began after taking the Avodart as I had not had these problems prior; and they have continued as of this writing. However, the Lortab is very effective each morning I wake up.
   A. You may consider reading the page on this website about prostate health.