Why not dutasteride? Is it really THAT unsafe?

Baller

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I've been on finasteride for close to two years. Why not use dutasteride? And why were the phase III trials eliminated? There's caution about its safety but if they're ok for other users why not for male pattern baldness sufferers?

Dutas seems to work just fine and the side effects seem similar to finasteride. Another additional side effect is increased testosterone in the scalp so an anti-androgen would be needed. Would spironolactone suffice?

Thanks in advice?
 

Red Rose

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Eur Urol. 2003 Jul;44(1):82-8.

Safety and tolerability of the dual 5alpha-reductase inhibitor dutasteride in the treatment of benign prostatic hyperplasia.

Andriole GL, Kirby R.

Division of Urologic Surgery, Washington University School of Medicine, 4960 Children's Place, Campus Box 8242, St. Louis, MO 63110, USA. andrioleg@msnotes.wustl.edu

OBJECTIVE: The objective of this paper is to examine safety and tolerability data from a number of recently completed clinical trials with the novel, dual 5alpha-reductase inhibitor, dutasteride.

METHODS: Intent-to-treat analyses were conducted on data for dutasteride 0.5 mg/day for drug-related adverse events, clinical laboratory test results, and prostate-specific antigen (PSA) levels derived from four large, randomised, double-blind clinical trials (n=5655). Further data were derived from a randomised, double-blind combination study of dutasteride 0.5 mg/day and tamsulosin 0.4 mg/day (n=327), and several safety studies conducted in healthy volunteers.

RESULTS: Data from two-year blinded clinical studies demonstrate that dutasteride is well tolerated, with a profile comparable with that of placebo. The exception is a modestly elevated incidence of impotence, decreased libido, ejaculation disorders, and gynaecomastia. Clinical laboratory test abnormalities were reported by <1% of patients treated with dutasteride, and abnormal values occurred with similar frequency versus placebo-treated patients. In a healthy volunteer study, when dutasteride was administered daily for 1 year, it did not significantly affect bone metabolism markers, bone mineral density or lipid profiles. Dutasteride reduced total serum PSA concentrations by approximately 50% following 6, 12, and 24 months of treatment but had no effect on free-to-total PSA levels. The safety profile of dutasteride did not differ from that of finasteride in a large, parallel-group, comparator trial. Additionally, when dutasteride was used in combination with an alpha(1)-blocker, the drug-related adverse event profiles were as would be expected for the individual agents.

CONCLUSIONS: Considered together, these data demonstrate dutasteride to be well-tolerated.


Contrast with Dr Lee's analysis:-

"Let's compare some of the differences between Propecia (finasteride) and Avodart (dutasteride):

Method of Action

Both block the formation of DHT from Testosterone, by inhibiting the enzyme 5-alpha reductase. Unlike Propecia (Merck) which inhibits the 5 AR-2 enzyme only, Avodart (Glaxo Smith Kline) inhibits both 5AR-2 and 5AR-1 enzymes.

Biological Model

Finasteride has a biological model and dutasteride does not. This quite simply means that there is much more safety data on Propecia than Avodart right now. The effects of 5AR type 2 deficiency, (the same environment Propecia creates) have been thoroughly studied for over 25 years in a group of patients in the Dominican Republic. The long-term "side effects" are no hair loss, and no prostate cancer. Patients with genetic 5AR-2 deficiency have no life-threatening disorders and there is no 5AR-2 present in their brain tissue. Conversely, there is no biological model for 5AR type 1 deficiency, which Avodart creates, and there are measurable levels of 5AR-1 in the human brain. Conclusion -- the blockage of 5AR-1 may have yet unknown neurological implications.
Dosage

Glaxo presented the results from the Phase II studies about 3 yrs. ago in a closed session only to the investigators involved in the study. From what was presented, the dutasteride side effects were very similar to the finasteride side effects (5 mg) tested dose. Dutasteride's sexual side effects were in the range of 3-4% versus 1-2% for finasteride 1mg (Propecia) and 3-4% for finasteride 5mg (Proscar). The results of the phase II trials did show that 2.5 mg of Avodart gave nearly 2-3 times more hair growth than finasteride did at a full 5 mg, resulting even in frontal hair growth in some men. However, these superior results were at a rather high 2.5mg dosage.

Both Finasteride and Dutasteride have originated as Prostate medications, but Dutasteride's prostate dose is actually lower than the tested dose for hair loss. Glaxo seems to be doing the exact opposite of Merck in this sense. Finasteride worked better on the prostate at the higher dose (5mg - Proscar), and for hair at a lower dose (1mg - Propecia). Dutasteride was released for the prostate at the lower dose (Avodart - 0.5mg), and was tested with results on hair loss at 5 times the dose (2.5mg). The higher the dose, the more potential for side effects.

Duration of Side Effects

The greatest concern however, is the potential duration of side effects. The long half life of dutasteride exceeds 240 hours vs. the rather short 6 to 8 hours for finasteride. There have been some cases where the DHT levels were still had only returned to 25% of their original levels nearly a YEAR after having discontinued Dutasteride. As a result, any dangers or side effects that may be seen from Avodart, whether directly related or as a hypersensitive or allergic reaction may take literally months to resolve.

Cost

Using dutasteride at the 2.5 mg dose will be quite expensive. Since many people are considering taking the 2.5mg dose, and Avodart is sold in 0.5mg capsules at nearly $90 for 30, basic math reveals quite a hefty monthly expense for this off-label treatment.

Dosing Frequency

On the other hand, the good news is that due to the long duration of action, the optimal dosage frequency might be once weekly or even once monthly. However, the fact remains that there is no clinical data to look towards regarding less frequent dosage schedules, so we doctors, and our patients, will be on our own. The ideal patient may be the person who has used Propecia for extended periods of time and saw results with no side effects.

Perspective?

I find that many patients are reluctant to take Propecia because of the sexual side effect disclaimers from the original TV ads by Merck. As a result, I find this irrational fervor to take Avodart worrisome, because we do not know about long-term side effects, nor how long the short-term side effects, if experienced, will last.

Conclusion

True, the preliminary results for hair growth are encouraging, but at what price? Glaxo has not done even presented the bare minimum needed as far as safety or dosing data for this drug to be used to treat hair loss. The most effective dose that carries the least chance of side effects. This is what Merck did for us with Propecia, and the data backing their recommendation is imperative to have. Perhaps the initial, ideal Dutasteride patient will be the one having had no problems with Propecia, who wants to improve their results. However, Dutasteride stays in the body for months, and maybe as long as a year. So if complications arise from its use, they will be around for a long time. Remember Fen-Fen for weight loss? Personally, I do not want my patients to be the guinea pigs."
 
G

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I recently have started messing around with .5 mg Duprost and was wondering the same thing.

I have no proof (I forgot where I read this), but the reason the phase 3 hair loss studies with Avodart have not been conducted is simply corperate politics. I guess 2 or 3 companies combined to form the now Glaxo-Blah Blah Blah somethin or nother company and they decided that the profits from Merck's Propecia were not satisfactory enough (above $50 million) to attempt to put an even more "scary" drug on the market.

But the Phase 1 and 2 studies combined with all the other Dutasteride studies indicates that it is a very safe drug (at least short term) and shows a greater potential to be better at fighting hairloss than Finasteride.

My personal opinion, after sifting through all the worry freaks, is that in 10 years this is going to be a miracle drug! I think that raising both my Testosterone and Estregen levels in the last couple weeks has given me an edge at everything I do. I feel like a higher human because of this modern age where crazy drugs are available to us.

I do worry about the dangers, mainly that it's not a hair loss drug but I like taking risks! I don't have anything to lose.
 

Cornholio

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http://www.hairlosstalk.com/newsletter/article224.htm

In the above link Dr Sawaya (who was an insider in the Phase II stage of Avodart research) explains why avodart was not studied beyond phase II for hair loss... Summary: money, and a limited market. With dutasteride's long half life (long side-effects if you are the unlucky one) finasteride remains a good first choice. Without phase III studies you are left to extrapolate benefits vs. risk from the phase II studies. Unfortunately this does not continue beyond 6 months so beyond that you really cannot say if/how benefits and risks will change if you are taking more than .5mg/day. At .5mg/day Avodart does have longer term prostate data which is reassuring, but the higher doses which seemed most promising for hair are not studied for safety or efficacy beyond 6 months.
 

Baller

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Thank you for the information. Some of this I have already seen but I just wanted what you guys thought.

For me, I thought that phase III wasn't conducted because the lack of profitability. Because of the long half-life of hte drug, what if you only had to use it 3 times per month or 1 time per week or 1 time per month? That wouldn't be that profitable for the company to have a pill (which you take once per month) for $60. Wouldn't people be astounded to pay that much for the pill?

Additionally, the side effects issue is a big one. There's just a lot of negative publicity regarding the drug.

Something I didn't know was the Dr. Lee says maybe there are Type 1 levels int he brain and possibly Dutas could affect these levels?

I wish someone who was bald with a lot of money could donate money to Glaxo-Wellcome to conduct phase III studies. Hey, if I was going to donate money, I would donate it to companies to find a cure for hairloss, not to stupid universities just to get my name on the building. Well, maybe for Harvard... Thanks again
 
G

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That's where I saw that, thanks cornholio.

Good point Baller about the long half life and how that would effect the profitability in this particular drug.

I can only wonder what kind of mysterious, crazy drugs are in the world today that would be of great benefit to humanity but are not on the market simply because of capitalism politics. I can only wonder what kind of drugs we as human beings have the capability of producing in the future.

A super drug....

cures depression, anxiety, baldness (male or female), sexual disfunction, acne, asthma, cancer, AIDs, over weight, under weight, anything! This pill will also give us every nutrient, amino acid, vitamin, and mineral our body can handel and we will recieve this presrciption at birth based on our genetic make up.

Everyone will be near perfect health, beauty, and intelligence!!

Aaahhhh, speculation....
 

Bryan

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Baller said:
For me, I thought that phase III wasn't conducted because the lack of profitability. Because of the long half-life of hte drug, what if you only had to use it 3 times per month or 1 time per week or 1 time per month? That wouldn't be that profitable for the company to have a pill (which you take once per month) for $60. Wouldn't people be astounded to pay that much for the pill?

I don't understand your point at all. Why wouldn't it be profitable for the company?? Don't you think a lot of guys might like the convenience of only having to take a pill once a week or once a month? And if they understand that they're still paying the same weekly or monthly cost that they did when they were taking a pill every day, then what really is the difference? Please explain.

Bryan
 

WithTheLidOff

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i agree....if it definatley works..or works at a high success with good results they would make a killing off of it. People losing their hair would pay anything for some chance of getting their hair back. Look at all the snake oil from the 70's and 80's. If they marketed it and got it backed by some medicla journals and let it loose in the media people wold only be too happy to spend the money. My guess (and its just a guess mind you) is that there were some problematic side effects which could have ended up costing the company money. A minute percentage of v**** users claimed ot have gone blind from the drug..and we're talking like 0.0002% and look at what thats gonna cost them. If i had any chance of going blind from a drug (or something similar) I wouldnt think twice about using it. Acne or some loss of libido I can deal with...but not that..i dont care how small the percentages are. Imagine living the rest of your life blind or with some sort of cancer and knowing that you did that to yourself because you wanted some hair.
 

Baller

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Bryan:

yeah, I understand your points. I already thought about them and think they're persuasive. However, consumers are affected by the quantity sold. Consumers feel like they get more if they get 30 tablets for $60 rather than 1 tablet for $60. When it's only 1 tablet, consumers feel like the pharmaceutical company is cheating them and that pharmaceutical companies can lower the price much more and still reap a profit. That's why pharmaceutical companies could not sell the 1 tablet for ungodly amounts of money (which they surely would want to) because consumers would not be willing to spend so much for 1 pill even though it has the same effect as 1 month's worth.

30 pills (a 1 month supply) for $100. 1 pill for $100. Which seems like a better deal? Many complain about Dr. Proctor's products and their prices. However, many people purchase almost as much money on a combination of other products like me (propecia, minoxidil, tricomin, nizoral et. al) but fail to notice that the money we spend may be as much as what Dr. Proctor's stuff is priced at. In addition, the regimen of using proxiphen and my regimen may have around the same efficacy (you can attest to that more than anyone) yet getting more seems better. While it's not a parallel example to the dutasteride pricing, the same sort of psychological effect is at play, I think.

Further, if only one pill is needed per month then wouldn't more people be afraid to take the drug because of potential side effects? If the drug is so powerful, then shouldn't it have devastating side effects also? That's what consumers would think... similarly to what people think are the drawbacks to halting propecia--> impotence and breasts. "You can't have your cake and eat it too" would be what overrides here.

Maybe a much stronger point is that if one tablet (or pill) could take care of 1 month, there is going to be more likelihood for generics, further pushing the price down of an authentic avodart dutasteride. If there is a fear of drug smuggling, of buying drugs over the border from India or Canada, this drug would be killed by generics or other replacements. Even for propecia there are people buying proscar and cutting them up in 4ths like me. I'm sure people would get around buying official legit avodart by going to other sources.

This might not all be accurate but I hope this is an explanation for you.
 

Bryan

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I don't think you're giving consumers enough credit for intelligence or even just common sense. When they would find out about it and see that a daily capsule costs (say) $2 for 0.5 mg, a weekly capsule costs $14 for 3.5 mg, and a monthly capsule costs $60 for 15 mg, I really think they'd have enough snap to understand it! :wink:

Bryan
 

techprof

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Bryan, good to know your views. Would you recommend dutasteride for any user if (1) he has results from propecia (2) if no significant results from propecia?

I agree with you on the profitability of dutasteride. May be one day we will have hair loss shots just like flu shots once a year. In that case I wouldn't mind paying 100s of dollars for a single shot that will give protection for one year.

If dutasteride is 50% more effective than finasteride, that is a lot in my opinion. It could be a difference one or two norwood scales.

It is insane to underestimate the intelligence of customers. Why take a pill every day if you need it only once a month or may be a year in the future?
 
G

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Dudes, your getting off topic!

for one, Baller is right about the psychology of marketing and yes Bryan, the average public is that stupid.

But I feel that this half life bullshit isn't what's stopping the profitability. A huge company isn't going to back away from producing a drug because their worried about sh*t that they don't know for sure. It is not a fact that dutasteride will be able to be as effective at 1,2,3,or whatever a month compared to daily due to the long half life. Prostate cancer patients who take dutasteride need to take .5 mg a day and the dose for hairloss we don't know (yet).

And you "withthelidoff", stop worrying so much! anything can take your eyesight away at any time. I would speculate your at more of a risk of going blind as we speak than you would taking v****. If you wanted to be totally safe, than you should lock yourself away from the world. But I think that would be a much more painful way to die... alone and afraid of unknown things! Stop scaring people please. Stop putting so much emphasis on things you can't control, stop putting value on your existence and live my friend!
 
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Paradise Lost said:
And you "withthelidoff", stop worrying so much! anything can take your eyesight away at any time. I would speculate your at more of a risk of going blind as we speak than you would taking v****. If you wanted to be totally safe, than you should lock yourself away from the world. But I think that would be a much more painful way to die... alone and afraid of unknown things! Stop scaring people please. Stop putting so much emphasis on things you can't control, stop putting value on your existence and live my friend!
Actually, most people maintain their eyesight their entire life. And you can certainly control whether or not you take a drug that's not been approved for the use you're using it for. You're a bit flippant in your comments about dutasteride, which smacks of lots of hopefullness. At least use the drug for a year/year and a half before you heap it with fulsome praise. I don't think abstence from dutasteride counts as locking oneself away from the world, and I don't think life is short enough to not put value on existence. You can't make dutasteride effective by force of will, so I would encourage skepticism of this drug until it's shown to be effective/safe. And yes, I'm taking it.
 

Baller

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Bryan, yeah, I understand your point. Wouldn't your calculation based on having to take a 15 mg pill once a month? What if avodart did research and figured that the ideal balance between safety and effectiveness would be at 7.5mg pill, once per month? Or 5mg, once per month? Avodart has already lost money on testing thru phase I and phase II. While this is a fixed and sunk cost, I can't see why Avodart would not go ahead with the project unless they thought the drug was profitable. Corporate politics is a reason I'm not comfortable with. Companies, to their own detriment, are only looking at the bottom line. If only a 7.5 mg pill is needed once per month, then Avodart wouldn't be able to push the price much higher than half of the current monthly cost for avodart prostate users, or else people would get around having to buy the once a month, 7.5 mg pill and get the 0.5mg once per day/prostate pills and take 15 of them, once a month. Avodart has a half-life of 240 hours, or around there? While finasteride is 6-8 hours. What this tells me, I'm not sure. It tells me that Avodart was afraid that the half-life of the drug may make their drug even less profitable than finasteride is for Merck.

Consumers don't make sense all the time. Companies often offer various products to fill different niches when the products are essentially the same. Why choose a name brand like Opti-Free for my contacts and pay $7.47 for a contact lens bottle or get the Target one for $1.99? This is the decision I was faced with yesterday. At times, the Target one says that it's not manufactured by so-and-so's brand but sometimes when you look at the back you can see the same patent numbers used for the generic brand and the brand name. This strikes me as very interesting, and I wonder if the products are essentially the same and that consumers are stupid to pay the extra money for the brand name. But consumers continue to do it.

Another strange reality is that consumers who shop at stores in the mall (I shop at banana republic) should realize not to get anything EVER at regular price. Stupid me, stupid others, we purchase things at regular price, and then find that our things are discounted in the future almost always. yet I don't want to wait until the thing goes on sale because I'm impatient and I want it now, now, now!

Last, the scare of finasteride still is with Avodart. People who are bald think that they can either have hair or their penis. This is something that is just soo scary for men that they'd rather be bald than have any potential libido problems. The strength of v****'s sales attest to the fact that for men, getting it up is the highest goal. If Merck can't reverse the negative publicity, who can? If there is dutasteride or finasteride, and finasteride is an intermediate between not taking anything and the extreme dutas, then maybe instead of people getting off of finasteride and then going to dutas, people would just choose finasteride or stick with it. I foresee people being too scared to take the extreme option and going with dutas from the beginning. So, dutas sales would be even less than with finasteride because most people would probably choose to go with the finasteride first out of safety then go onto dutas if it doesn't work within a year or two. Dermatologists would not prescribe dutas first for a first-time patient unless their situation was really progressed.
 

Bryan

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techprof said:
Bryan, good to know your views. Would you recommend dutasteride for any user if (1) he has results from propecia (2) if no significant results from propecia?

Oh, I think it's reasonable to try dutasteride in either of those cases, if you're willing to experiment with such a more potent drug.

techprof said:
I agree with you on the profitability of dutasteride. May be one day we will have hair loss shots just like flu shots once a year. In that case I wouldn't mind paying 100s of dollars for a single shot that will give protection for one year.

Yes, I agree. The "convenience factor" would probably be a significant one for many people.

However, having said that, it's probably correct that it's actually easier to remember to take a medication EVERY DAY, rather than something like every second, third, or fourth day. My guess is that it would have to be either once-a-week or once-a-month dosing that would be an advantage over once-a-day dosing. What do the rest of you guys think about that?

techprof said:
If dutasteride is 50% more effective than finasteride, that is a lot in my opinion. It could be a difference one or two norwood scales.

dutasteride isn't 50% more effective than finasteride. Not when you compare haircounts to placebo users, which is the only logical way to do it. The difference between dutasteride and finasteride is a smaller figure than that.

techprof said:
It is insane to underestimate the intelligence of customers. Why take a pill every day if you need it only once a month or may be a year in the future?

Right. It's a convenience factor, nothing more...

Bryan
 

Baller

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One additional thing I didn't mention because my post was already long enough, were the potential side effects and potential litigation. Any car manufacturer weighs making the car safer vs. potential litigation from an unsafe car part/recall likelihood. I'm sure that Glaxo-Wellcome also weighed the likelihood of potential litigation from avodart and side effects from using avodart.

Why is it that Glaxo would be ok to have people use avodart for prostate problems but not for hairloss and what implications would this have in terms of potential litigation against Glaxo? The populations that would be using avodart for hairloss would be likely to be much younger, so the potential side effects of libido and gyno and other side effects would be magnified for the young hairloss sufferers. [This is my very un-educated guess…] I'm even surprised that so far to date, there have been no major lawsuits against merck that we know of (maybe there have been settlements) about long-term side effects from using the drug. Impotent and developed breasts for ____ duration because of taking finasteride?

Also, Dr. Lee mentions that "there have been some cases where the DHT levels were still had only returned to 25% of their original levels nearly a YEAR after having discontinued Dutasteride. As a result, any dangers or side effects that may be seen from Avodart, whether directly related or as a hypersensitive or allergic reaction may take literally months to resolve." So, in Glaxo would say "side effects will go away in most cases by one year"?? How scary would that be? The long half-life of the avodart drug seems to be a double-edged sword, one that may allow for a convenient once a month use, but may cause side effects that persist much longer after the drug usage is stopped..

Being optimistic, let's say that Glaxo thinks dutasteride can get as much sales and profits as finasteride and has the same low reported side effects. Maybe Glaxo would still not be willing to do it. And reality may be much worse. Lower sales/profits and more side effects and greater likelihood of litigation? Why would Glaxo want to spend so much on FDA testing on a drug that doesn't get that much revenue/profits in the beginning, much less a product that could have very strong side effects?

Time to go play some basketball....
 
G

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Yea Alopecia nate, I suppose your right.

Can we stop writing such long and boring posts. Nobody reads this thread anymore and I thought it was heading in a good direction.
 

Bryan

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Paradise Lost said:
Dudes, your getting off topic!

for one, Baller is right about the psychology of marketing and yes Bryan, the average public is that stupid.

Really? And yet ANYBODY who has any basic knowledge about hairloss treatment (for example, a typical reader of hairloss forums like this one) knows all about the difference between Propecia and Proscar tablets; there are probably a million people around the world who know enough to buy Proscar tablets and cut them into quarters, thus saving a lot of money over buying Propecia tablets. If that's now common knowledge in the hairloss community, what makes you think that people would be unable to comprehend the concept of paying more money for tablets/capsules with larger amounts of active drug? :wink:

Paradise Lost said:
But I feel that this half life bullshit isn't what's stopping the profitability. A huge company isn't going to back away from producing a drug because their worried about sh*t that they don't know for sure. It is not a fact that dutasteride will be able to be as effective at 1,2,3,or whatever a month compared to daily due to the long half life. Prostate cancer patients who take dutasteride need to take .5 mg a day and the dose for hairloss we don't know (yet).

I don't understand that paragraph. I don't know if you're talking about the increased FLUCTUATION of serum DHT levels due to less-frequent dosing, or if you're confusing less-frequent dosing with LOWER AVERAGE LEVELS of drug intake. Please clarify which of those you mean.

Bryan
 

Bryan

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Baller said:
Bryan, yeah, I understand your point. Wouldn't your calculation based on having to take a 15 mg pill once a month? What if avodart did research and figured that the ideal balance between safety and effectiveness would be at 7.5mg pill, once per month? Or 5mg, once per month?

Well, the ideal dose for hairloss is a separate issue. All I was talking about is the CONVENIENCE FACTOR of being able to take a dose less often (like once-a-week or once-a-month), as opposed to every day.

Baller said:
Avodart has already lost money on testing thru phase I and phase II. While this is a fixed and sunk cost, I can't see why Avodart would not go ahead with the project unless they thought the drug was profitable. Corporate politics is a reason I'm not comfortable with. Companies, to their own detriment, are only looking at the bottom line. If only a 7.5 mg pill is needed once per month, then Avodart wouldn't be able to push the price much higher than half of the current monthly cost for avodart prostate users, or else people would get around having to buy the once a month, 7.5 mg pill and get the 0.5mg once per day/prostate pills and take 15 of them, once a month.

That logic has never stopped Merck from charging different amounts (per milligram of active drug) for Propecia and Proscar! :wink:

The logical thing to do would be to charge approximately equal amounts of money per unit of active drug, REGARDLESS of the absolute size of the dose. I wish Merck and other companies would do that. It would simplify things.

Baller said:
Avodart has a half-life of 240 hours, or around there? While finasteride is 6-8 hours.

At the "steady-state" levels achieved with the standard dose of 0.5 mg/day, the half-life can be up to 5 weeks or so.

Baller said:
What this tells me, I'm not sure.

The most obvious thing is that it gives you a LOT of flexibility in dosing. You can take either daily or weekly doses (possibly even monthly ones), without too much fluctuation in blood levels of the drug.

Baller said:
It tells me that Avodart was afraid that the half-life of the drug may make their drug even less profitable than finasteride is for Merck.

Why is that? Please explain.

Bryan
 

Baller

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Paradise Lost: I apologize for taking up webspace on hairlosstalk. I suppose I mistakenly believe that people may want to know why a company such as Glaxo-Wellcome didn't go along with the whole phase III process. This was a learning process for me, as I tried to figure out on my own (with some help from Dr. Lee and other studies) why they didn't go ahead. If you didn't want to read this thread, it's ok. Maybe one or two out there might find it helpful. If you don't, that's too bad.

Bryan: The question of why the half-life of dutasteride may be less profitable than finasteride was sort of answered in my 3:32pm post. You only commented on my the post that dated 2:10pm.
 
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