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Dutasteride 복용시 우려되는 부작용 - 필독

21년 전
2,694

아래 글은 Hairlosstalk.com에 게시된 Edwin S. Epstein, MD의 글 입니다.
자세히 읽어 보시고, 왜 미국 의사들이 Dutasteride를 탈모 방지/치료제로 처방해 주지 않는지 생각해 보시기 바랍니다.
특히, Dutasteride계열의 약을 Finasteride계열의 약처럼 하루에 한알씩 먹는 것이 얼마나 위험한지 글을 참조해 보세요.
나중에 시간이 되면 좀 더 다른 글들을 찾아보고 번역해서 올리겠습니다.

Edwin S. Epstein, MD
Certified, American Board of Hair Restoration Surgery
Member, International Society of Hair Restoration Surgery

There is a lot of interest in the use of Avodart (active ingredient: Dutasteride) as an off-label medication for the treatment of hair loss. Since Dutasteride is only approved to treat benign enlargement of the prostate, the off-label use to treat hair loss should be approached cautiously. Dutasteride is marketed as Avodart by Glaxo Smith Kline at a dosage of 0.5mg. It is in gel capsule form, so cutting it up will be difficult, and must be kept in a cool place so they will not stick together. It costs $75-95 for a 1 month supply at 0.5mg.
I have prescribed Propecia since its FDA approval in 1997 to over 1000 patients, and have used it myself for over 3 years without side effects. I believe that knowing the risks and benefits of a medication is essential to deciding whether or not it is the right choice for the treatment of condition in question.

*** Duration of Side Effects
The greatest concern however, is the potential duration of side effects. The long half life of dutasteride exceeds 240 hours vs. the rather short 6 to 8 hours for finasteride. There have been some cases where the DHT levels were still had only returned to 25% of their original levels nearly a YEAR after having discontinued Dutasteride. As a result, any dangers or side effects that may be seen from Avodart, whether directly related or as a hypersensitive or allergic reaction may take literally months to resolve.

*** Dosing Frequency
On the other hand, the good news is that due to the long duration of action, the optimal dosage frequency might be once weekly or even once monthly. However, the fact remains that there is no clinical data to look towards regarding less frequent dosage schedules, so we doctors, and our patients, will be on our own. The ideal patient may be the person who has used Propecia for extended periods of time and saw results with no side effects.

*** Perspective?
I find that many patients are reluctant to take Propecia because of the sexual side effect disclaimers from the original TV ads by Merck. As a result, I find this irrational fervor to take Avodart worrisome, because we do not know about long-term side effects, nor how long the short-term side effects, if experienced, will last.

*** Conclusion
True, the preliminary results for hair growth are encouraging, but at what price? Glaxo has not done even presented the bare minimum needed as far as safety or dosing data for this drug to be used to treat hair loss. The most effective dose that carries the least chance of side effects. This is what Merck did for us with Propecia, and the data backing their recommendation is imperative to have. Perhaps the initial, ideal Dutasteride patient will be the one having had no problems with Propecia, who wants to improve their results. However, Dutasteride stays in the body for months, and maybe as long as a year. So if complications arise from its use, they will be around for a long time. Remember Fen-Fen for weight loss? Personally, I do not want my patients to be the guinea pigs.

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