Does Avodart (Dutasteride) Cause Urine to Smell?
No, Avodart (dutasteride) does not cause changes in urine smell based on available clinical evidence and established adverse effect profiles.
Known Adverse Effects of Dutasteride
The documented side effects of dutasteride from major clinical trials and guidelines do not include urine odor changes. The established adverse effects are:
- Sexual dysfunction: Impotence, reduced libido, and ejaculation disorders occur more frequently than placebo, though incidence is generally low and decreases over time 1
- Breast-related effects: Gynecomastia can occur and, unlike other sexual side effects, does not consistently decrease over time 1
- PSA reduction: Dutasteride reduces serum PSA levels by approximately 50% within 6-12 months, which is important for prostate cancer screening 2
- General tolerability: Dutasteride is generally well tolerated with good long-term safety profiles maintained for up to 4 years 3, 1
Important Distinction: Drugs That DO Cause Urine Odor/Color Changes
If a patient reports urine changes while on dutasteride, consider other causes:
- Rifampin and rifabutin universally cause orange discoloration of bodily fluids including urine, and patients must be warned of this effect at treatment initiation 4
- Concentration/hydration status can affect urine odor and appearance 4
- Urinary tract infections commonly cause malodorous urine 4
Clinical Approach If Urine Changes Occur
If a patient on dutasteride reports urine odor changes, evaluate for alternative causes:
- Perform urinalysis to evaluate for infection, blood, or concentration 4
- Assess hydration status 4
- Review all concurrent medications for known causes of urine changes 4
- Consider urinary tract infection, which is a common cause of malodorous urine 4
Key Caveat
The absence of urine smell changes in the documented adverse effect profile from multiple large-scale trials (including the 4-year CombAT study with 4,844 patients) strongly suggests this is not a dutasteride-related effect 5, 3, 6, 1. If urine changes occur, investigate other etiologies rather than attributing them to dutasteride.