Is a combination of dutasteride and tamsulosin better for treating benign prostatic hyperplasia?

This study looked at the safety and effectiveness of taking both Dutasteride (Avodart) and Tamsulosin (Flomax) at the same time to treat benign prostatic hyperplasia (BPH). It concluded that the combination treatment was more successful than tamsulosin given alone. 

Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. An enlarged prostate can affect bladder function and have a negative impact on quality of life. Treatments for BPH may include medication or surgery. Medications for BPH often result in many side effects while surgery can lead to complications.

Tamsulosin is an alpha blocker. This means that it relaxes the muscles in the bladder neck. The relaxation of these muscles allows for easier urine flow out of the body. Dutasteride is in a class of drug called 5 alpha reductase inhibitors. It slows the growth of the prostate tissue. Combination treatments of tamsulosin and dutasteride aim to improve urine flow, bladder symptoms and quality of life for patients who have BPH. 

607 patients who had BPH were included in the study. For the first 4 weeks of the study, every patient took a placebo drug (doesn't contain any active drug). After these 4 weeks, patients were randomly assigned to take 0.5mg dutasteride and 0.2mg tamsulosin or 0.2mg tamsulosin only. The drugs were given to the patients for 2 years. BPH symptoms were assessed every 3 months. Safety of the drugs was also assessed. 

The group taking both dutasteride and tamsulosin showed significant improvements in BPH symptoms, urinary function and prostate volume after 2 years. The group taking both drugs also had a decreased risk of surgery for BPH. BPH symptoms were seen to improve in both groups but at month 15 the improvement was less significant in the tamsulosin only group. 

Drug side effects included sexual dysfunction. A few patients also had some mild cardiovascular issues. Mild sexual dysfunction occurred in 7.3% of the dutasteride and tamsulosin group and 3.3% of the tamsulosin only group. 2 patients in the tamsulosin group reported breast enlargement. 

This study concluded that dutasteride and tamsulosin showed better improvements in BPH symptoms, urinary function and quality of life than tamsulosin treatment alone. 

The authors note that there was a lack of statistical power. This means that the statistics obtained from the study may be ineffective. 

If you are interested in learning more about dutasteride and tamsulosin to treat BPH, contact your doctor.