Minoxidil (Rogaine, Hairmax) - Uses, Dose, MOA, Side effects

Minoxidil Spray is available by the brand names Hairmax and Rogaine among others. It is used for the treatment of scalp hair loss (alopecia androgenetica).

Minoxidil Uses:

  • Alopecia:

    • It is used as a topical spray for the treatment of alopecia androgenetica of the scalp.

Note: Avoid patients prone to developing hypotension and those with cardiac diseases.

"A story of our patient with hypotension caused by using topical minoxidil"

  • A young male presented in our outpatient department with postural dizziness and syncopal attacks for the past two weeks.
  • He had undergone a hair transplant two weeks back and was on treatment using minoxidil spray.
  • For the workup of syncopal attacks, he had already been through a lot of investigations, however, all his investigations were normal.
  • On inquiry regarding his medication history, he denied taking any medications, however, on direct questioning, he admitted using a topical spray.
  • He was asked to stop using the minoxidil spray, after which he did not experience any syncopal attacks or postural dizziness.

Minoxidil Dose in Adults:

Minoxidil (Rogaine, Hairmax) Dose in the treatment of Alopecia: Topical:

Note: For hair growth, a continuous treatment regimen for at least four months may be required.

  • Males:

    • Foam, aerosol 5%:
      • Apply a half capful two times a day.
    • Solution 2% or 5%:
      • Apply 1 mL two times a day.
  • Females:

    • Foam, aerosol 5%:
      • Apply a half capful once a day.
    • Solution 2%:
      • Apply 1 mL two times a day.

Use in Children:

Not indicated.


Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer’s labeling 

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling


Side Effects of Minoxidil (Rogaine, Hairmax):

  • Dermatologic:

    • Local erythema
    • Pruritus
  • Systemic Side effects:

    • Hypotension
    • Postural dizziness.

Contraindications to Minoxidil (Rogaine, Hairmax):

OTC labeling should not be used in self-medication situations.

  • If the degree of hair fall is greater than the one stated in the product labeling.
  • Individuals who experience sudden hair loss, or patchy hair loss.
  • Individuals without a history of hair loss in their family;
  • Hair loss during pregnancy and childbirth is common
  • Individuals who have a diagnosed scalp disorder.
  • Children 18 years old and younger.
  • If your scalp is reddened, itchy, inflamed or infected, consult your doctor immediately.
  • Concomitant use of topical scalp medication.
  • Women should not use products for men.

Warnings and precautions

  • Color changes for hair:

    • Hair color and texture may change as a result of treatment.
  • Heart disease

    • Systemic absorption can occur, which could lead to hypotension, and fluid or electrolyte changes. Patients with heart disease should not use it.

Minoxidil (systemic): Drug Interaction

Risk Factor C (Monitor therapy)

Alfuzosin

The hypotensive effects of blood pressure-lowering medications may be strengthened.

Amphetamines

Decrease the therapeutic benefit of antihypertensive drugs.

Antipsychotic Agents (Second Generation [Atypical])

Blood Pressure Lowering Agents may enhance the hypotensive effect of Antipsychotic Agents (Second Generation [Atypical]).

Atazanavir

May increase the serum concentration of Minoxidil (Systemic).

Barbiturates

May enhance the hypotensive effect of Blood Pressure Lowering Agents.

Benperidol

May enhance the hypotensive effect of Blood Pressure Lowering Agents.

Brigatinib

May diminish the antihypertensive effect of Antihypertensive Agents. Brigatinib may enhance the bradycardic effect of Antihypertensive Agents.

Brimonidine (Topical)

May enhance the hypotensive effect of Blood Pressure Lowering Agents.

CycloSPORINE (Systemic)

May intensify the negative or harmful effects of minoxidil (Systemic). There have been reports of severe hypertrichosis.

Dapoxetine

May strengthen Minoxidil's orthostatic hypotensive effects (Systemic).

Dexmethylphenidate

Decrease the therapeutic benefit of antihypertensive drugs.

Diazoxide

The hypotensive effects of blood pressure-lowering medications may be strengthened.

DULoxetine

The hypotensive impact of DULoxetine may be enhanced by blood pressure lowering medications.

Herbs (Hypertensive Properties)

May lessen the effectiveness of antihypertensive agents.

Herbs (Hypotensive Properties)

The hypotensive effects of blood pressure-lowering medications may be strengthened.

Hypotension-Associated Agents

The hypotensive action of hypotension-associated agents may be strengthened by blood pressure lowering medications.

Levodopa-Containing Products

Levodopa-Containing Products' hypotensive effects may be strengthened by blood pressure-lowering medications

Lormetazepam

The hypotensive effects of blood pressure-lowering medications may be strengthened.

Methylphenidate

May lessen the effectiveness of antihypertensive agents.

Molsidomine

The hypotensive effects of blood pressure-lowering medications may be strengthened.

Naftopidil

The hypotensive effects of blood pressure-lowering medications may be strengthened.

Nicergoline

May increase the hypotensive effects of blood pressure lowering medications.

Nicorandil

Blood Pressure Lowering Agents may have a greater hypotensive impact.

Nitroprusside

Nitroprusside's hypotensive impact may be strengthened by blood pressure-lowering medications.

Pentoxifylline

May enhance the hypotensive effect of Blood Pressure Lowering Agents.

Pholcodine

Pholcodine's hypotensive impact may be strengthened by blood pressure lowering medications.

Phosphodiesterase 5 Inhibitors

The hypotensive effects of blood pressure-lowering medications may be strengthened.

Probenecid

Might raise the serum level of minoxidil (Systemic).

Prostacyclin Analogues

BP lowering medications may have an enhanced hypotensive impact.

Quinagolide

The hypotensive effects of blood pressure-lowering medications may be strengthened.

Valproate Products

Might raise the serum level of minoxidil (Systemic).

Yohimbine

May lessen the effectiveness of antihypertensive agents.

Risk Factor D (Consider therapy modification)

Amifostine

Amifostine's hypotensive impact may be strengthened by blood pressure lowering medications. Treatment: Blood pressure-lowering drugs need to be avoided for 24 hours before amifostine is administered when used at chemotherapeutic dosages. Amifostine should not be used if blood pressure lowering treatment cannot be stopped.

Obinutuzumab

The hypotensive effects of blood pressure-lowering medications may be strengthened. Management: Take into account temporarily stopping blood pressure-lowering drugs 12 hours before the start of the obinutuzumab infusion and keeping them off until 1 hour after the infusion is finished.

Risk Factor X (Avoid combination)

Bromperidol

The hypotensive impact of bromperidol may be enhanced by blood pressure lowering medications. Blood Pressure Lowering Agents' hypotensive effects may be lessened by bromperidol.

 

Monitoring Parameters:

Patients with hypertension, those taking drugs to decrease blood pressure concurrently, and those with underlying cardiac conditions should all have their blood pressure checked.


How to administer Minoxidil (Rogaine, Hairmax)?

Topical:

  • It is intended for topical use over the scalp only. Avoid using it on other parts of the body.
  • Applying it directly to the scalp's regions where hair is thinning and massaging it in with your fingertips is recommended. 
  • After an application of the medication, the hands need to be cleaned. Dry off the solution.
  • Also, read the manufacturer's labeling for details.

Foam:

  • When touched by warm fingers, the foam may dissolve. Before usage, wash your fingers in cold water and pat them dry.

Mechanism of action of Minoxidil (Rogaine, Hairmax):

  • It causes hair growth by increasing the blood flow as a result of its effects on the blood vessels and stimulating the hair follicles that are in the resting state.
  • It belongs to the second-generation antihistamines. 
  • It has a lengthy half-life and is a selective inhibitor of platelet-activating factor (PAF) and peripheral histamine (H-1) receptors. When used in greater dosages, it also prevents the degranulation of mast cells and the production of cytokines, most notably TNF-alpha in human mast cells and monocytes.

Onset:

    • 1 to 2 hours

International Brand Names of Minoxidil:

  • Minoxidil for Men
  • Rogaine Women's
  • Apo-Gain
  • Hair Regrowth Formula
  • Minox
  • Rogaine
  • Allegro
  • Alomax
  • Alopexy
  • Hair Regrowth Treatment MenHair Regrowth Treatment Men
  • Alopexyl
  • Alostil
  • Aloxid
  • Aloxidil
  • Apo-Gain
  • Bald
  • Bold Stop
  • Rogaine Men's Extra Strength
  • Capillus
  • Da Fei Xin
  • Eminox
  • Growell
  • Rogaine Mens
  • Hair Max
  • Hairex
  • Hairgain
  • Hairgrow
  • Hudson Moxidil Solution
  • I Medicate
  • Kenacin
  • Lacovin
  • Locemix
  • MI-X
  • Minodil
  • Minox
  • Minoxi
  • Minoxi-5
  • Minoxidil Isac
  • Minoximen
  • Minoxin
  • Minoxiten
  • Minoxyl
  • Moxidil
  • Neocapil
  • Neoxidil
  • Nuhair
  • Piladex
  • Pilfud
  • Pilogan
  • Recrea
  • Recrea Forte
  • Regaine
  • Regaine Extra Strength For Men
  • Regaine For Men
  • Regaine For Unisex
  • Regaine For Women
  • Regaine Forte
  • Regro
  • Regroe
  • Regrou
  • Regrow
  • Regrowth
  • Remox
  • Rexidil
  • Rogaine
  • Scalpmad
  • Scino
  • Splendora
  • Tricoxane
  • Trugain
  • Xenogrow
  • Ylox
  • Zitoxin

Minoxidil Brand Names in Pakistan:

Minoxidil Lotion 2 % in Pakistan

Minoxy Danas Pharmaceuticals (Pvt) Ltd

 

Minoxidil Lotion 5 %W/W in Pakistan

Minoxy Plus Danas Pharmaceuticals (Pvt) Ltd

Comments

NO Comments Found