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What's Avodart?


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What's Avodart?

Avodart is a drug which affects the way testosterone is used in the body.

Avodart is the brand name. The chemical name is dutasteride.

It is approved for use to treat enlargement of the prostate.

Some doctors use Avodart "off label" (something that is not one of the approved uses):

  • to shrink the prostate before other treatments such as surgery or radiation;
  • as a way of extending the amount of "time off" during intermittent hormone treatment for prostate cancer;
  • as the third part of "triple hormone therapy", sometimes called ADT3 (Androgen Deprivation Therapy 3).
  • after primary hormone treatment fails, as an addition to the secondary hormone treatment drug Ketoconazole.
  • in the prevention of prostate cancer in carefully selected men believed to be at significant risk for this disease.
  • to treat male hair loss.

Some terms you will come across in the literature about Avodart:

DHT

Dihydrotestosterone – as the prostate uses testosterone, it is first turned into DHT.

5-alpha- reductase

An enzyme that does the conversion of testosterone to DHT.

There are two types of 5-alpha-reductase called Type I and Type II.

5-alpha- reductase inhibitor

A drug that stops 5-alpha-reductase from turning testosterone into DHT.

  • Proscar (finasteride) is drug which stops 5-alpha-reductase Type II from turning testosterone to DHT.
  • Avodart (dutasteride) is a newer drug which stops both 5-alpha reductase Types I & II from turning testosterone to DHT.

Today's Encore topic is on a study which showed that Avodart's sister drug Proscar (finasteride) gave men who took it during breaks in ADT an extra 15 months total time off ADT, compared to men who did not take it during the breaks. Doctors who use this type of treatment mostly use the newer Avodart for this purpose.

While on ADT, the men had ADT3 (another big topic in itself, but basically an implant like Zoladex or Lucrin + Cosudex + Proscar.)

The Pharmaceutical Benefits Scheme (PBS) only pays for "on label" uses of a drug. As the use of Avodart in this way is currently (Sunday, 4 December 2011) "off label", it will cost you around $75 per month.

There are other costs as well – in side effects, interaction with other drugs, and effects on other medical conditions. Your doctor will take these into account if Avodart is under consideration.

Click here to see this encore topic:

http://advancedprost...termittent-adt/

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Guest tonybrown

Jim,

Great summary of Avodart. Just what I wanted to know. What are the side effects? I am wondering if I should have it now for a while if it prolongs the time before psa starts to rise for those with metastases. If the side effects are not too bad then why not? Even if you are free of metastases then being on that for maybe 3 years is worth it. Give the cancer time to die if there is a little bit there. Seems to me that prostate cell life is approx 6 years. So the longer you can keep the cancer cells from growing the better. Get to 6 years & that must mean you have killed nearly all of it. I am now 2 years 9 months years since I went on ADT. Avodart sounds better than being on Zoladex. You still have testosterone for other uses in your body.

Tony

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Tony

From the side effects below, you can see Avodart is indeed better than Zoladex.

Just to make the point clear for anyone new to the topic:

Avodart is not used as a replacement for Zolaxex or any other implant.

While you are off ADT, Avodart is used to prolong the time-off period.

There is evidence that this works with the family of drugs that Avodart belongs to.

While you are on ADT, Avodart is used by some doctors in the hope that its anti-cancer effects will kill off some of your cancer.

It is always used in addition to an implant like Zoladex or Lucrin.

Although there are studies that attest to its anti-cancer effects, there are no studies that have been done to confirm that the Avodart is doing what is hoped in this usage.

Many of the doctors that add Avodart while you are on ADT also add Cosudex, Casodex (bicalutamide) or Eulexin (flutamide) or Nilandron (nilutamide) to the mixture.

This is called by some "triple hormone therapy" - whole new topic.

Avodart side effects reported. n is the number of men reporting.

Month 0-6 ( n = 2,167 )

  • Impotence: 4.7%
  • Decreased libido: 3%
  • Ejaculation disorders: 1.4%
  • Breast disorders: 0.5%

Month 7-12 ( n = 1,901 )

  • Impotence: 1.4%
  • Decreased libido: 0.3%
  • Ejaculation disorders: 0.5%
  • Breast disorders: 1.1%

Month 13-18 ( n = 1,725 )

  • Impotence: 1%
  • Decreased libido: 0.1%
  • Ejaculation disorders: 0.4%
  • Breast disorders: 0.8%

Month 19-24 ( n = 1,605 )

  • Impotence: 0.8%
  • Decreased libido: 0.3%
  • Ejaculation disorders: 0.1%
  • Breast disorders: 0.6% - From wiki.

Cheers

Jim

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