From the Guidelines
Avodart (dutasteride) is the preferred treatment option for patients with benign prostatic hyperplasia (BPH) and enlarged prostates, while Vesicare (solifenacin) is used to treat overactive bladder symptoms. When considering the treatment of BPH, the most recent and highest quality study 1 suggests that 5-alpha-reductase inhibitors (5-ARIs) like Avodart are effective in reducing symptoms and improving quality of life for patients with enlarged prostates. The study found that Avodart, which blocks the conversion of testosterone to dihydrotestosterone, can shrink the enlarged prostate and improve urinary flow. In contrast, Vesicare is an anticholinergic medication used to treat overactive bladder symptoms by relaxing the bladder muscles to reduce urgency, frequency, and incontinence. Key differences between the two medications include their mechanisms of action, target conditions, and side effect profiles. Avodart may take several months to show full effects for BPH symptoms, while Vesicare typically begins working within 1-2 weeks for overactive bladder. Side effects differ as well, with Avodart potentially affecting sexual function and PSA levels, and Vesicare commonly causing dry mouth, constipation, and blurred vision. Combination therapy with 5-ARIs and alpha blockers may be offered to patients with LUTS associated with demonstrable prostatic enlargement, as judged by a prostate volume of >30cc on imaging, a PSA >1.5ng/mL, or palpable prostate enlargement on DRE 1. However, the choice of medication should be based on the individual patient's specific urological condition and medical history, and patients should consult their healthcare provider to determine the most appropriate treatment option. It is essential to consider the patient's overall health, potential interactions with other medications, and the potential risks and benefits of each treatment option when making a decision. Ultimately, the goal of treatment is to improve the patient's quality of life and reduce the risk of complications associated with BPH and overactive bladder.
From the Research
Avodart vs Vesicare
- Avodart (dutasteride) is a 5-alpha reductase inhibitor used to treat benign prostatic hyperplasia (BPH) by shrinking the prostate and improving urinary symptoms 2.
- Vesicare (solifenacin) is an antimuscarinic agent used to treat overactive bladder (OAB) symptoms, which can be associated with BPH 3.
Comparison of Avodart and Vesicare
- Avodart has been shown to improve urinary symptoms and reduce the risk of acute urinary retention and BPH-related surgery in men with moderate to severe BPH 2.
- Vesicare has been shown to improve OAB symptoms in patients with BPH who have persistent symptoms after treatment with dutasteride 3.
Combination Therapy
- The combination of dutasteride and solifenacin has been shown to be effective in improving urinary symptoms and reducing the risk of sexual dysfunction in men with BPH and severe lower urinary tract symptoms 4.
- The addition of solifenacin to dutasteride therapy has been shown to improve OAB symptoms in patients with BPH who have persistent symptoms after treatment with dutasteride 3.
Efficacy and Safety
- Dutasteride has been shown to be effective in improving urinary symptoms and reducing the risk of BPH-related complications, with a good safety profile 2, 5.
- Solifenacin has been shown to be effective in improving OAB symptoms, with a good safety profile 3.
- The combination of dutasteride and solifenacin has been shown to be safe and effective in improving urinary symptoms and reducing the risk of sexual dysfunction in men with BPH and severe lower urinary tract symptoms 4.