Alfusin D

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What Alfusin D is and how it works

Alfusin D is a combination tablet containing two medicines that target BPH at different mechanisms:

• Alfuzosin 10 mg ER — an alpha-1 adrenoceptor antagonist that relaxes prostate, bladder-neck and urethral smooth muscle, improving flow within days.
• Dutasteride 0.5 mg — a dual 5-alpha-reductase inhibitor that blocks the conversion of testosterone to dihydrotestosterone (DHT). Lower DHT shrinks the prostate by ~25% over 6–12 months and lowers the long-term risk of acute urinary retention and BPH-related surgery.

This dual approach is supported by the CombAT trial (Combination of Avodart and Tamsulosin, 4-year data), which showed superiority of dual therapy over either drug alone for symptom score, flow rate, retention risk and need for surgery in men with prostates >30 mL.

Dosering og indtagelse

One tablet once daily, after the same meal each day — usually breakfast or dinner. Swallow whole with water; do not crush, chew or open the tablet (the alfuzosin portion is an ER matrix). Improvement in flow appears within 1–2 weeks (alfuzosin component); prostate shrinkage and the full reduction in retention risk take 6–12 months (dutasteride component). Long-term treatment is usually intended.

Bivirkninger

Lægemiddelinteraktioner

Important PSA note

Dutasteride halves serum PSA within 6 months. Your urologist should double the measured PSA before interpreting it for prostate-cancer screening. If your PSA rises above the new (halved) baseline while on treatment, that is a flag for further investigation — do not assume the drug is failing.

Who should not take Alfusin D

• Women, children, adolescents (dutasteride is teratogenic and there is no female indication)
• History of orthostatic hypotension or first-dose syncope
• Svær leversvigt
• Concurrent strong CYP3A4 inhibitors
• Known hypersensitivity to alfuzosin, dutasteride, or other 5-alpha-reductase inhibitors (e.g. finasteride)

Ofte stillede spørgsmål

How is this different from alfuzosin alone?

Alfuzosin alone improves flow within days, but does nothing for prostate size. Adding dutasteride shrinks the gland over 6–12 months and reduces long-term retention and surgery risk. The combination is for men whose gland is enlarged, not just symptomatic.

Why must my partner avoid handling the tablets?

Dutasteride is absorbed through skin and can disrupt male foetal development. Whole tablets are coated and safe; broken or leaking tablets must not be touched by women who could be pregnant.

Can I donate blood while on Alfusin D?

No. Dutasteride has a 5-week half-life; do not donate blood during treatment and for 6 months after stopping, to protect potentially pregnant recipients.

Will my PSA reading still be useful?

Yes — your clinician simply doubles the measured value to get an “equivalent” PSA. Any rise above the halved baseline is investigated normally.

How long before I notice an effect?

Flow rate improves within 1–2 weeks (alfuzosin). Symptom score (IPSS) typically drops 4–6 points by 3 months. Prostate shrinkage and the retention-risk benefit accumulate over 6–12 months (dutasteride).

Is sexual side-effect risk additive?

Partly. Each drug independently reduces ejaculate volume; dutasteride adds 3–7% rates of decreased libido and erectile dysfunction. Most are reversible on stopping, though dutasteride effects can persist for weeks after the last dose.

Can I crush or split the tablet?

No. Alfuzosin is in an extended-release matrix; crushing dumps a whole day’s dose at once and causes severe hypotension. Swallow whole.

What happens if I stop taking it?

Alfuzosin’s flow benefit fades within 1–2 weeks. Dutasteride’s prostate-size reduction reverses over 6–12 months. Symptoms typically return.

Can I switch to dutasteride alone later?

Some men whose symptoms are dominated by gland size rather than tone do drop the alpha-blocker after 6–12 months. Discuss the timing with your urologist — do not self-switch.

Is this safe long-term?

Yes — both components are licensed for chronic use. Long-term safety data exists out to 4 years (CombAT) and informally beyond. Annual urology review is recommended.

Andre blære- og prostata-medicin

• Silofast (silodosin) — alpha-blocker monotherapy, more selective
• Alfusin (alfuzosin 10 mg ER) — alpha-blocker alone
• Alfusin Tab (alfuzosin 2.5 mg) — alternative starting dose
• Urotel XL (tolterodine ER) — for storage-symptom-dominant LUTS
• Cystone — herbal urinary support adjunct

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