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Urimax D — tamsulosin 0.4 mg + dutasteride 0.5 mg (Cipla Inc). Combined alpha-1A blocker + dual 5-alpha-reductase inhibitor for moderate-to-severe BPH with prostate >30 mL or PSA >1.5 ng/mL. Treats symptoms (alpha) AND shrinks the gland over 6-12 months (5ARI).
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Waarom bestellen bij MedsBase
Urimax D ships from a WHO-GMP certified manufacturer in plain packaging, billed through a regulated payment processor (the statement descriptor reads a regulated card-payment processor — never MedsBase or any medication name). Every order carries our 20-business-day Reshipment Assurance.
Dutasteride is teratogenic. Pregnant women must NOT handle leaking or crushed capsules — skin absorption can affect male fetal genital development. Men taking dutasteride must NOT donate blood for at least 6 months after the last dose (5-week half-life). Capsules should be swallowed whole.
Why combination therapy
The CombAT trial (Combination of Avodart and Tamsulosin, n=4,844, 4 years) showed that dutasteride + tamsulosin was superior to either monotherapy for moderate-to-severe BPH, particularly in men with:
- Prostate volume >30 mL
- PSA >1.5 ng/mL (a marker of prostate volume)
- IPSS >13 (moderate-to-severe symptoms)
Combination therapy reduced acute urinary retention by 67.8% and BPH-related surgery by 70.6% compared with tamsulosin alone over 4 years.
Dutasteride approximately halves serum PSA after 6 months. When interpreting PSA in a man on dutasteride, double the measured value before applying age-based reference ranges. A PSA that fails to halve, or that rises while on dutasteride, is suspicious for prostate cancer and warrants urology review — do not assume the rise is benign.
Dosering
One capsule once daily, 30 minutes after the same meal each day. Swallow whole — do NOT crush, chew, or open. Improvement in symptoms (alpha component) is noticeable in 1-2 weeks; gland-shrinkage effect (dutasteride) takes 3-6 months and continues to improve out to 12 months.
Bijwerkingen
- Tamsulosin component: dizziness, retrograde ejaculation (~5-15%), nasal congestion, postural hypotension
- Dutasteride component: reduced libido, erectile dysfunction (~4-7%), reduced ejaculate volume, gynaecomastia (rare)
- Both: generally well tolerated; sexual side effects are the most common reason for stopping
- IFIS: tamsulosin component still causes Intraoperative Floppy Iris Syndrome — tell any ophthalmologist before cataract surgery
Tamsulosin causes Intraoperative Floppy Iris Syndrome — disclose to any ophthalmologist before cataract surgery, even years after stopping.
Veelgestelde vragen
When will I notice improvement?
Urinary flow improves within 1-2 weeks (alpha blocker effect). Gland-shrinkage and reduced retention/surgery risk takes 3-6 months and continues to improve out to 1 year (dutasteride effect).
Should I keep the alpha blocker forever?
CombAT data showed continued benefit at 4 years with combination therapy. Some men can later step down to dutasteride alone after symptoms have stabilised on combination, but talk to your urologist before changing — withdrawal of the alpha blocker can cause flare in flow symptoms.
Can I father a child while taking this?
Dutasteride affects semen parameters and crosses into semen. Most clinicians recommend stopping dutasteride at least 6 months before conception attempts. Discuss with your fertility specialist.
What about PSA monitoring?
Dutasteride approximately halves PSA. Double the measured PSA when interpreting against age-based ranges. Any rise from the new baseline warrants prostate cancer evaluation.
Cataract surgery?
Tell the ophthalmologist about tamsulosin use even if you stopped years ago — it causes Intraoperative Floppy Iris Syndrome and changes the surgical approach.
Sexual side effects — will they reverse?
Most reverse on stopping the drug, though some men report persistent symptoms. If sexual side effects are unacceptable, discuss switching to a tamsulosin + finasteride 5 mg combination (similar gland-shrinkage benefit, slightly different side-effect profile).
Can I take this with sildenafil/tadalafil for ED?
Yes, but separate by ≥4 hours to avoid additive hypotension. Daily tadalafil 5 mg has the cleanest profile and is itself approved for BPH symptoms.
Wat als ik een dosis vergeet?
Take it when you remember if it is still close to the normal time. If it is nearly time for the next dose, skip the missed one — do not double up.
Why is dutasteride preferred over finasteride here?
Dutasteride inhibits both type-1 and type-2 5-alpha-reductase isoenzymes, achieving more complete DHT suppression (~95% vs ~70% with finasteride). Some clinicians choose finasteride 5 mg for cost or side-effect reasons; clinical outcomes are broadly similar.
Does this prevent prostate cancer?
REDUCE trial showed dutasteride reduced low-grade prostate cancer detection but increased high-grade cancers slightly. It is NOT used for prostate cancer prevention. Continue routine cancer surveillance per local guidance.
Other BPH & Urinary Medications
- Temsunol — tamsulosin 0.4 mg monotherapy — for symptomatic relief without gland shrinkage
- Temsunol F — tamsulosin + finasteride 5 mg — alternative 5ARI combo, lower cost
- Alfusin — alfuzosin 10 mg — non-selective alpha blocker
- Silofast — silodosin — most selective alpha-1A; higher retrograde-ejaculation rate
- Finpecia — finasteride 1 mg for hair-loss; 5 mg version for BPH
























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