INTERACTIONS: Since dutasteride is metabolized by the CYP 3A4 isoenzyme, plasma dutasteride concentration may increase in the presence of CYP 3A4 inhibitors, and the clearance of dutasteride decreases with simultaneous application of CYP 3A4 inhibitors with verapamil (37%) and diltiazem (44%). At the same time, the clearance of dutasteride does not decrease with the use of another antagonist of calcium channels with amlodipine. The decrease in clearance and the corresponding increase in the effect of dutasteride in the presence of inhibitors of CYP 3A4 is not of great clinical significance due to the wide spectrum of drug safety. In vitro isoenzymes CYP 1A2, CYP 2C9, CYP2 C19 and CYP 2D6 do not participate in the metabolism of dutasteride in humans, dutasteride does not inhibit the enzymes of the cytochrome P450 system in humans participating in the metabolism of drugs. In vitro studies have established that dutasteride does not displace warfarin, diazepam, or phenytoin from binding to plasma proteins, nor do these components replace dutasteride. The interaction of dutasteride with tamsulosin, terazocine, warfarin, digoxin and colestyramine was studied. Clinically significant interaction was not detected. Although no specific studies on the interaction with other drugs have been conducted, about 90% of all patients in clinical studies of dutasteride received other concomitant therapy. No clinically significant adverse reactions were observed with simultaneous use of dutasteride with antihyperlipidemic drugs, ACE inhibitors, β-adrenoreceptor blockers, calcium channel blockers, GCS, diuretics, NSAIDs, phosphodiesterase type V inhibitors and quinolone antibiotics. According to a study to study the interaction of tamsulosin or terazocine in combination with Avodart for 2 weeks, no signs of pharmacokinetic or pharmacodynamic interaction were detected.
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