Medicines

Here you will find the recommendations we have made about the use of individual medicines in Lancashire.

Dutasteride

Brand: Avodart®
NICE TA: 
Indication: Benign prostatic hyperplasia
Disease category: Endocrine system
Commissioning responsibility: CCG
PbR excluded: No

Background

Dutasteride when used to treat Benign Prostatic Hyperplasia (BPH) should be reserved for initiation by consultant urologists, in patients who present with haematuria secondary to prostate bleeding. In this instance patients should be reviewed at 6 months by their primary care clinician for consideration of switching to finasteride. This is because:
• Although dutasteride has a longer ½ life leading to a more prolonged and consistent suppression of serum and intraprostatic Dihydrotesterone (DHT), trial data suggests it has a similar effect to finasteride in reducing prostate volume, improving Qmax and urinary symptoms associated with BPH.at 3 and 12 months. Additionally the EPICS study found no difference in overall numbers of adverse events between finasteride and dutasteride
• Dutasteride is also significantly more expensive than the alternative 5‑α reductase inhibitor Finasteride.

Recommendation

LMMG recommendation: Amber0
Click here to find the definitions for the colour classifications

Reason for decision:  Suitable for GP prescribing following recommendation/initiation by specialist

Supporting documents:

BJUI - Comparison of dutasteride and finasteride for treating benign prostatic hyperplasia

Decisions of Lancashire local decision making groups:

NHS Blackburn With Darwen CCG and NHS East Lancashire CCG NHS Blackpool CCG NHS Chorley and South Ribble CCG and NHS Greater Preston CCG NHS Fylde and Wyre CCG NHS Morecambe Bay CCG NHS West Lancashire CCG

Amber

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Black

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