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Reduction by Finasteride or Dutasteride and Food Intake in Men
From the Center for Research in Reproduction and Contraception, Divisions of General Internal Medicine and Endocrinology, Metabolism and Nutrition, Department of Medicine, University of Washington Medical School, Seattle, Washington.
| Correspondence to: Dr John K. Amory, University of Washington, Box 356429, 1959 NE Pacific St, Seattle, WA 98195 (e-mail: jamory{at}u.washington.edu). |
reductase inhibitor dutasteride (D), elevates serum T in
medically castrated men to the normal range. In this study, we sought to
determine the impact of 1) finasteride (F) and 2) food intake on the serum T
and dihydrotestosterone (DHT) levels observed after the oral administration of
T in oil. Therefore, we conducted a pharmacokinetic study of oral T in oil,
alone or with D or F, in the fasting and fed states in normal men whose
endogenous T production was suppressed by the GnRH antagonist acyline. After
acyline administration, 7 healthy men (mean age 31 ± 8 years) were
sequentially administered five 400-mg doses of oral T in sesame oil once
daily. The first dose of oral T (T-alone) in oil was given while fasting
without F or D. The second (fasting) and third (fed) doses were administered
after pretreatment with F (T + F). Four days later, the fourth (fasting) and
fifth (fed) doses were administered after pretreatment with D (T + D). Blood
samples for measurement of serum T and DHT were obtained before T dosing and
0.5, 1, 2, 3, 4, 6, 8, 10, 12, and 24 hours after each administration. In the
fasting state, 24-hour area-under-the-curve of serum T after oral T
administration was significantly greater with coadministration of either D or
F compared with T-alone (126 ± 36 nmol-h/L [T-alone] vs 287 ± 98
nmol-h/L [T + F] vs 236 ± 82 nmol-h/L [T + D]; P < .05 for T + F and
T + D vs T-alone). Administration of the T with food nonsignificantly
decreased serum T levels compared with fasting administration. The
administration of oral T in oil combined with either F or D results in serum T
levels adequate to treat men with testicular failure. Additional studies of
the combination of oral T in oil with 5-reductase inhibitors as a novel
form of oral T therapy are warranted.
Key words: Androgen, hypogonadism, metabolism, acyline
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