Dutasteride 500micrograms/5ml oral solution

BackgroundAndrogenic alopecia (AGA) is a common condition characterized by progressive hair loss influenced by dihydrotestosterone (DHT). While oral dutasteride has shown efficacy in treating AGA, concerns about systemic side effects have prompted interest in localized treatments such as intralesional administration.AimsThis systematic review evaluates the effectiveness and safety of intralesional dutasteride for treating AGA in adults.MethodsFollowing PRISMA guidelines, we conducted a comprehensive search of multiple databases for studies involving adults (≥ 18 years) with AGA treated with intralesional dutasteride. Eligible studies included randomized controlled trials, non-randomized studies, cohort studies, and observational studies. Exclusion criteria were animal studies, duplicate publications, and studies lacking relevant outcome data. The primary outcomes were improvements in hair density, hair thickness, and photographic evidence of hair growth. Secondary outcomes assessed safety, including local and systemic adverse events. Data extraction and quality assessment were independently performed by two reviewers.ResultsIncluded studies consistently reported improvements in hair density and thickness following intralesional dutasteride treatment, with photographic evidence supporting visual improvement. Treatment was generally well tolerated, with minimal adverse events such as mild scalp irritation and no significant systemic effects reported. However, the studies varied in methodology, sample size, and follow-up duration.ConclusionsIntralesional dutasteride appears to be a promising treatment option for AGA, offering localized efficacy with a favorable safety profile. Nonetheless, the current evidence is limited by heterogeneity and a lack of large-scale, high-quality trials. Further standardized research is needed to confirm these findings.

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PurposeAlpha-blockers and 5-alpha reductase inhibitors (5ARIs) are well-established treatments for symptoms of benign prostatic hyperplasia (BPH). Despite their therapeutic benefits, concerns have been raised regarding a potential association between these medications and an increased risk of dementia. However, current evidence remains inconsistent, highlighting the need for further evaluation. This study aims to assess the potential dementia risk among patients receiving alpha-blockers and 5ARIs.MethodsFollowing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines (PROSPERO CRD42025643431), 7 databases were systematically searched through December 2024 for studies examining the association between alpha-blockers or 5ARIs and dementia risk in patients with BPH. Risk of bias was assessed using the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) tool. A Bayesian network meta-analysis was performed to estimate risk ratios with 95% credible intervals and to generate surface under the cumulative ranking curve (SUCRA) values.ResultsFive multicenter studies involving 3,650,434 patients (mean age, 71.1 years) and demonstrating an overall low risk of bias were included. The network analysis indicated that neither alpha-blockers nor 5ARIs were significantly associated with an increased risk of dementia compared with no treatment. However, SUCRA values suggested a relatively higher probability of dementia risk for 5ARIs (finasteride and dutasteride), followed by tamsulosin, doxazosin, terazosin, and alfuzosin.ConclusionThis study found no significant association between the use of alpha-blockers or 5ARIs and increased dementia risk. These findings may assist clinicians in making more informed prescribing decisions, particularly for older male patients with BPH. Further large-scale research with extended follow-up periods is needed to strengthen the evidence across all BPH medications.

Abstract licence: CC BY-NC

Introduction5α-reductase inhibitors (5-ARIs) are most commonly used to treat benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA). Preclinical and clinical studies suggest that in patients with AGA treated with 5-ARIs, a subset reports sexual adverse events, including decreased libido, erectile dysfunction, and ejaculatory disorders. This review explores the development of sexual dysfunction in patients with androgenetic alopecia due to the use of 5-ARIs, emphasizing their importance in the clinical diagnosis of health disorders coexisting with hair loss.MethodsA systematic review was conducted by searching electronic databases, including MEDLINE, Scopus, Web of Science and Google Scholar, according to the PRISMA guidelines. The search was limited to articles published in English and up to December 2025. Key search terms included "5α-reductase inhibitors" or "5-ARIs" or "finasteride" or "dutasteride" AND "side effects" or "sexual side effects" or "sexual" or "sexual dysfunction" AND "androgenetic alopecia" or "male pattern hair loss" or "female pattern hair loss." Data synthesis included findings from 41 studies, comprising 33 primary-evidence studies in AGA/MPHL/FPHL populations and 8 supporting-evidence studies providing pharmacokinetic, mixed-indication, or comparative context.Results5-ARIs are effective therapies for androgenetic alopecia and are generally well tolerated. Across placebo-controlled RCTs evaluating oral finasteride 1 mg in men with AGA, sexual adverse events were reported in 1.9-6.7% of treated patients compared with 0.9-3.9% in placebo groups, with most events mild and reversible upon discontinuation. Topical finasteride 0.25% was associated with lower rates of sexual adverse events (2.8%) compared with oral finasteride (4.8%). For dutasteride 0.5 mg, sexual adverse events ranged from 4.1 to 12.0% across RCTs, compared with 4.0-5.0% in placebo groups. No sexual adverse effects were consistently reported in women treated with 5-ARIs for AGA. In most reports, the effects were transient and reversible after discontinuation.ConclusionOverall, clinicians should counsel patients that most sexual side effects reported in controlled AGA studies are infrequent, mild, and reversible, but individual susceptibility varies. Shared decision-making, careful monitoring of sexual function, and further high-quality long-term studies-using standardized definitions of sexual dysfunction and persistence-are needed to quantify risks better and identify vulnerable subgroups.

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ObjectiveTo critically evaluate the existing evidence base surrounding the efficacy of preoperative 5-alpha reductase inhibitor (5ARI) administration in the reduction of perioperative complication rates in transurethral resection of prostate (TURP).MethodsIn April 2025, a systematic search of on-line databases was conducted to identify randomised controlled trials (RCTs) that compared surgical outcomes and complication rates in patients undergoing TURP for benign prostatic hyperplasia (BPH) who were treated preoperatively with 5ARI (finasteride or dutasteride) as compared to placebo/none. The efficacy of preoperative finasteride was evaluated through outcomes related to blood loss, rate of blood transfusion, and operative time. The physiological mechanism of 5ARI treatment was evaluated through microvessel density (MVD) and vascular endothelial growth factor (VEGF) expression of the resected specimen.ResultsA total of 30 RCTs met the inclusion criteria for this meta-analysis in which a total of 2974 patients underwent TURP for BPH (1464 5ARI: 1410 Control). Intraoperative blood loss was significantly lower among 5ARI-treated patients (Z = 6.37, mean difference [MD] = -82.58 mL, 95% confidence interval [CI] -107.98 to -57.18; P 3, P ConclusionPreoperative administration of 5ARIs significantly reduces intraoperative blood loss and risk of requiring blood transfusion in patients undergoing TURP for BPH. Even short durations (2 weeks) of 5ARI therapy can significantly reduce prostate vascularity.

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