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ello anyone used duodart to reduce the size of a prostate ? just wondering if it's worth trying.

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  • Posted

    Duodart is a combination of dutasteride and tamsulosin. I have been using dutasteride and alfuzosin for about two months. Alfuzosin is an alpha blocker like tamsulosin but my research indicates that it is safer especially with regards to floppy iris syndrome (search some threads on this forum). It seems like alfuzosin is prescribed more in Europe and tamsulosin in the US. Alfuzosin is a newer alpha blocker. Be sure to educate yourself on these medications because there are side effects.

    It's been two months. Originally, I started on tamsulosin, but alfuzosin works better for me (I keep a daily urination journal). Just last week I noticed some additional improvement, so maybe the dutasteride is starting to work (it typically takes 6 months or longer for the dutasteride to provide benefit).

    The combination of a 5-alpha reductase enzyme inhibitor like dutasteride and an alpha blocker seems to result in a loss of sex drive in many men. This was the case for me for about 4 to 6 weeks. However, just last week my sex drive increased back to just about normal [but maybe that's because I was in Hawaii 😃]

    You haven't mentioned your history or what tests have been done. If you are the type of person who likes to have quantitative data at hand to monitor progress, then you should have a PSA (and I recommend free PSA as well) number before you start dutasteride. Dutasteride will reduce your PSA significantly (by something like 50%). If it doesn't that might be an indication of prostate cancer (but I'm not a doctor so talk with your urologist).

    Also, I recommend you have your prostate size measured prior to starting. How can one tell if dutasteride has reduced the prostate size by around 20 to 25% (as claimed in the literature), if you don't know what the size was before starting it. The digital rectal exam is not accurate at all for determining prostate size (DRE size for me was 350% lower than prostate size measured by imaging). If you don't like the idea of having a probe inserted into your rectum for a TRUS (trans rectal ultrasound), you can have a TAUS (trans abdominal ultrasound) instead to get an idea of the size of your prostate. It isn't as accurate as TRUS, but if you are just trying to see if the dutasteride has reduced the size of the prostate after 6 to 12 months of dutasteride use, I think it should work for that. That's what I'm planning to do, but my uro has not suggested that I do that. At the same time, I don't think he will object. My plan is to have the TAUS done after six months and a TRUS after 12 months. I already have prostate size readings from both TAUS and TRUS prior to starting dutasteride.

    Good luck.

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  • Posted

    Hi John,

    I had a bad reaction and there are a lot of bad side effects and it didn't help!

    I've also seen it on lists of the worst drugs to take.

    Best of luck!

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  • Posted

    Hi Warning!!! For your own future peace of mind fully research any drug you are prescribed!!!

    I was treated for BPH since 1990, with alpha blockers (4mg a day) 2006 to 2015. Urologists had known since 1995 these would need an increase in dosage after 2 years use but no one had bothered to do the research for this to be prescribed. When I sought an increase in 2013 I was prescribed Duodart (5ARI Dutasteride + 4mg alpha blocker) from March 2013 to March 2014 This took my alphas to 8mg a day anyway.

    My highest PSA over 25 years of testing was 3.8 yet I was MRI/biopsy diagnosed with 3+4 PCa and gland was removed 2015. The Dutasteride was supposed to reduce prostate volume by I think 20% and PSA by half. PSAs were 2.99 September 2012, 1.15 in March 2014 and 2.62 in June 2015. Volumes by U/S (not exact) were 74cc Sept 2012 and 68cc July 2015. Likely improvement, if any, only lasted during consumption.

    I was unaware of the pre release trial possibility for Dutasteride to increase the risk of serious prostate cancer before my diagnosis. My former Urologist countered with Gleason 7s are not serious cancers. My new Urologist says 7s become 8s and 9s over time and not just more aggressive 7s. The Australian supplier of Duodart has reported a small number of Prostate Cancers to our Database of Adverse Events, including mine.

    We almost daily have warnings of so many products and actions that could cause us to fall victim of Cancer. Some we discard others we decide to avoid the risk. I believe the chance of Dutasteride causing my cancer is very small but the worst of it is I did not have to take that chance. I had enough Prazosin (alpha blocker) to increase the dose myself without any Dutasteride risk!!!!!!!!!

    Barrie Heslop

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    • Posted

      Hi Barrie:

      100% agree that anyone using 5 ARI or alpha blockers need to research these drugs. However with regards to 5 ARI such as dutasteride potentially causing serious prostate cancer, there is a counter argument. That argument is that the 5 ARI drugs reduce prostate gland volume by such a degreee that the ability to identify high-grade tumors via prostate biopsy is improved. By reducing the size of the prostate these drugs facilitate earlier detection of cancers.

      Don't get me wrong - I dislike taking any drugs but I reached a point where I had to do something as I was having more episodes of great difficulty trying to urinate at night. Since taking dutasteride and alfuzosin my situation has improved significantly. I have been keeping a urination journal for some time now and just this week I'm starting to have voids that exceed 200 mL during the daytime. That's about where I was five years ago. We'll see how things go.

      I'm hoping to be able to delay a procedure until better methods come along. One that I am particularly hopeful about is fexapotide triflutate, which is currently seeking FDA approval. A couple of shots in the prostate and it supposedly reduces the size by over 20% in a month. On the flip side the company that makes it will go bankrupt if the drug isn't approved, so this is a concern regarding the glowing reports they publish.

      Nothing about BPH is easy. Best of luck to you.

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  • Posted

    Hi Rdemyan

    Yes I am NOW well aware of the GSK argument about the detection improvement of the smaller prostate. The positive and adverse outcome numbers from trials were pretty insignificant also. The FDA I saw came up with 1 in 200 PCa adversities for one. The supplier sponsored 5ARI trials were “designed” to fail the PCa test. The PSAs and low number biopsy hits of participants made it likely any or all could have had PCa going in. They then wanted the FDA to approve the drugs as a cancer preventative on the low range outcome and then discount the high range outcome as POOR “study design”.

    Post prostatectomy I just don’t like the science of it. Unnaturally manipulating cell activity just sounds dangerous. Science today is so wonderful and complicated but browsing the net I find so many “we don’t fully understand” or we don’t know”. So many of these are in the BPH/PCa arena. I was watching a documentary on Round-up the other night. I always only had slight concern about gene alteration of plants and hormone changes to animals to improve food production. My concerns however were raised somewhat by the involvement of the benefactors in the science and the supervising officials motivations.

    In Australia budget restrictions result in only medications or TURPs for BPH. There are so many other treatments available elsewhere we don’t even hear of down under. Our PCFA says 3,300 Australian men a year die from ProstateCancer. We repeatedly hear that “more men die with rather than from PCa” as if 3,300 of us are insignificant. The 25 years failure to research more than 4mg of Alpha Blockers is a good example of how much research goes into Prostate treatment when there is no billion dollar benefit to pharmaceutical companies.

    My main concern was being told I had to make my own “risk vs benefits” assessment while the risk was not properly displayed.

    Barrie Heslop

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