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α-blocker + 5α-reductase inhibitor

Tamsulosin with dutasteride

Brand names: Combodart

Adult dose

Dose: 400 micrograms / 500 micrograms PO OD
Route: PO
Frequency: OD

Clinical pearls

  • Moderate-severe BPH with prostate enlargement
  • Halves PSA — adjust interpretation

Contraindications

  • Pregnancy (handling)
  • Severe hepatic impairment
  • Hypersensitivity

Side effects

  • Postural hypotension
  • Sexual dysfunction
  • Gynaecomastia
  • IFIS
  • Reduced PSA (~50%)

Interactions

  • Strong CYP3A4 modulators
  • Other α-blockers
  • PDE5 inhibitors

Monitoring

  • PSA (adjusted)
  • BP

Reference: BNF; NICE NG106; https://bnf.nice.org.uk/drugs/tamsulosin-with-dutasteride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.