Avodart (Dutasteride) vs Other BPH Treatments: Full Comparison

• Veronica Ashford
• 9 Oct, 2025
• 1 Comments

When it comes to managing an enlarged prostate, Avodart (dutasteride) is a prescription pill that works by blocking the hormone conversion that fuels prostate growth. In this guide we’ll break down how Avodart stacks up against the most common alternatives, so you can see which option fits your health goals, budget, and lifestyle.

What is Avodart (Dutasteride) and how does it work?

Dutasteride is a dual 5-alpha-reductase inhibitor. It blocks both type1 and type2 isoforms of the enzyme, cutting the conversion of testosterone into dihydrotestosterone (DHT). With DHT levels reduced, the prostate shrinks over months, easing urinary flow and lowering the risk of acute urinary retention.

• Typical dose: 0.5mg once daily.
• Approved in the UK for benign prostatic hyperplasia (BPH) and for reducing the risk of prostate cancer in certain men.
• Effect on prostate volume: average reduction of 25‑30% after 6months.

Key alternatives to consider

Below are the most widely prescribed or discussed options for BPH and why you might pick one over another.

• Finasteride - a single‑type2 5‑alpha‑reductase inhibitor (brand names: Proscar, Propecia).
• Tamsulosin - an alpha‑blocker that relaxes prostate smooth muscle (brand name: Flomax).
• Saw Palmetto - a herbal supplement that may modestly inhibit 5‑alpha‑reductase.
• Transurethral Resection of the Prostate (TURP) - surgical removal of excess prostate tissue.

Head‑to‑head comparison table

How to choose the right option for you

1. Assess symptom severity. If you have mild‑to‑moderate urinary urgency but no significant prostate enlargement, an alpha‑blocker like tamsulosin may give quick relief without shrinking the gland.
2. Consider long‑term goals. For men who prefer a non‑surgical route and are comfortable with gradual improvement, a 5‑alpha‑reductase inhibitor (Avodart or finasteride) is better because it actually reduces gland size.
3. Review side‑effect tolerance. Avodart blocks both enzyme types, which can lead to slightly higher rates of sexual side effects compared with finasteride, but also offers a larger size reduction.
4. Factor in cost and insurance. In the UK, Avodart is often listed on the NHS for BPH, but if a private prescription is required, the monthly price gap can be noticeable.
5. Check contraindications. Men with a history of prostate cancer should discuss the modest cancer‑risk‑reduction claim of dutasteride with their urologist.

Talking with a urologist is essential. They can run a PSA test, measure prostate volume via ultrasound, and tailor the regimen.

Safety notes and drug interactions

Both Avodart and finasteride are metabolized by the liver enzyme CYP3A4. Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) can raise drug levels and increase side‑effect risk. Avoid using these together unless your doctor adjusts the dose.

• Do not start dutasteride if you are planning to father a child; it can affect sperm quality for up to 6months after stopping.
• Alpha‑blockers should not be combined with other blood‑pressure‑lowering agents without monitoring.
• Herbal supplements can vary in potency; choose standardized extracts of saw palmetto (>45% fatty acids) for any chance of benefit.

Real‑world experiences

John, a 62‑year‑old from Manchester, switched from finasteride to Avodart after his prostate volume plateaued at 40mL. After 8months on dutasteride his ultrasound showed a reduction to 30mL, and his nocturnal trips to the bathroom dropped from five to two. The trade‑off was a temporary dip in libido, which resolved after a few weeks.

Emma, a 58‑year‑old who prefers “natural” routes, tried saw palmetto for a year. She noticed a modest improvement in weak urine flow, but her PSA remained unchanged. Her urologist later added low‑dose tamsulosin, which gave the quick symptom relief she wanted without surgical intervention.

Bottom line

If you need a drug that actually shrinks the prostate and you’re okay with a slower onset, Avodart is the most potent oral option on the market today. Finasteride offers a similar mechanism with slightly fewer sexual side effects, while tamsulosin works faster but doesn’t reduce gland size. Saw palmetto can be a low‑risk adjunct, and surgery remains the definitive choice for severe obstruction.

• Avodart
• Dutasteride
• BPH treatment
• Finasteride comparison
• 5-alpha-reductase inhibitor