Urimax D
Urimax D (Tamsulosin 0.4 mg + Dutasteride 0.5 mg) — Cipla brand of the BPH combination therapy targeting both urinary symptoms and prostate gland shrinkage over 3-12 months.
✓ Verificat medical de Morgan Ellis — Cercetător farmaceutic · 8 ani de experiență · Ultima recenzie: mai 2026
Quick Answer
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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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.
Dosing
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.
Side effects
- 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.
Întrebări frecvente
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.
What if I miss a dose?
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
More options in Alpha Blocker
Clasificate în funcție de volumul recent de comenzi MedsBase — ce aleg alți clienți în această categorie.
| Concentrație | 0.4 mg + 0.5 mg |
|---|---|
| Cantitate | 30 Tablet/s, 60 Tablet/s, 90 Tablet/s |
| Pharma Form | Tablet/s |
| Manufacturer | Cipla Inc |
| Treatment | Benign prostatic hyperplasia (BPH) |
| Generic Brand | Tamsulosin + Dutasteride |
Urimax D
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