Proscar and flomax

There have been a series of studies on Proscar, Avodart and Flomax. Generally they have been shown to reduce the risk of cancer and to help in controlling cancer. However, the studies also showed that there was a tendency toward higher grade in the cancers that developed. These drugs didn't cause that, but rather isolated the higher risk from the others.

My uro has been a principle investigator on all these studies including Redeem and Reduce which showed the positive aspects of Avodart and Proscar. Also the studies Combine and CombAT which showed the effects of combing the drugs with Flomax.

Overall the findings favored Avodart over Proscar and Jalyn (a combination of Avodart and Flomax in one capsule). I have been on Jalyn for four years as part of my treatment plan and will continue on it as a maintenance drug indefinitely. Based on my experience I would ask your urologist about Jalyn. The Proscar advantage is that it is generic, but the trials showed me the Jalyn was worth the additional cost.

JNF gave you very thorough answer, which I completely agree with. I would have hoped your doctor would have ruled out BPH (and prostatitis) as sources of increased PSA before rushing you into biopsy. But better late than never.

How big is your prostate and what is your PSA history? PSA density (=PSA/prostate size) is sometimes used as an indicator that there may be a problem beyond BPH. If it is much greater than .15, there may be another problem.

Now that you've had a negative biopsy, your insurance may cover a PCA3 urine test. Another good indicator is prostate health index, PHI, a simple new blood test that is better at detecting PC than either PSA or % free PSA alone. You can find out how to get it at this website

- Allen

Allen psa rose from 3.5- 8.3 over 5psa tests from Jan.- late Sept.
Pca3 was 8 in Aug. %free was 20 and 24 done twice over last 2+ months. Last size in sept. Was 53.5 ml so if I figure it right and use the latest psa then we have a density of about .15.


Jnf So the study shows the combo of advo.- flomax is best.
Not sure what is meant in your last line " Avodart is favored Over proscar when not used in combination with flomax".
Sorry for my misunderstanding, just trying to be sure.
Just got flomax and proscar this week a 30 day supply refillable for a year. Not sure if I should call the doc or not.
Again thanks to all.

rpw,

So all your biochemical indicators look pretty good. That should allay your fears.

IMHO, there's not that big a difference between finasteride (Proscar) and dutasteride (Avodart). Avodart blocks one extra enzyme that Proscar doesn't, but that second enzyme is a minor contributor to DHT in most men. Some guys find that Avodart works for them when Proscar doesn't. Jalyn is just a convenient combination, and a way for GlaxoSmithKline to make a few extra bucks. It combines .5 mg of Avodart with .4 mg of tamsulosin (generic name of Flomax). However, some guys find that .8 mg Flomax works for them when .4 mg doesn't, or that some other alpha-blocker, like Rapaflo, works better - so you are getting convenience at the expense of flexibility in medicating. Also, Jalyn is much more expensive than the two generics - finasteride and tamsulosin - if purchased separately.

So, since you already have the two generics, why not try them and see if they work for you?

BTW, the third kind of medication that is FDA-approved for lower urinary tract symptoms is Cialis. It may be covered by insurance if prescribed for that purpose.

- Allen

Allen
Been there, done that. See my history. I believe that finasteride caused me to wait too long to get a biopsy because it understated my PSA. Is my view justified?
Bob

rpw,

I agree with Allen that you should go ahead and use the drug combination you have. You might consider Jalyn or some other combination in the future based on your level of success with the current combination. There have been attempts to produce a generic version by Watson, but GSK is, of course, fighting that. Actually they don't make a lot of money from Jalyn compared to other drugs. In 2012 worldwide revenues were less than $100 million for Jalyn and about $600 million for Avodart. My uro gets a lot of free Jalyn and that helps me. Probably half of my supply comes from him, greatly reducing the cost. At my pharmacy, Jalyn is billed at about $270 for a 90 day supply. This is far less than the online drug cost estimates I see, but still more than the generic combination. My pharmacist says that many prescriptions come in for Jalyn, but often insurance companies require the generic two drug combination to be filled, instead. My insurance company(BCBS) has never required the generic combination.