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Nice TA:

Commissioning responsibility:


PbR excluded:


BNF chapter:
Genito-urinary system


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 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.


LSCMMG Recommendation:

Amber level 0

Reason for decision:

Suitable for GP prescribing following recommendation/initiation by specialist

Supporting documents:

Decisions of Lancashire local decision making groups

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Last Updated: 01 - Oct - 2014