Minoxidil is a medication primarily used for the treatment of hair loss. It's available in various forms, including topical solutions and foams, and it's typically applied directly to the scalp. Originally, minoxidil was developed as an oral medication for high blood pressure, but researchers discovered its hair growth side effect during clinical trials.
The exact mechanism of how minoxidil stimulates hair growth isn't fully understood, but it's believed to prolong the anagen (growth) phase of the hair follicle cycle and increase blood flow to the scalp. This results in improved hair follicle function and, in some cases, the regrowth of hair in areas where it has been lost or thinning has occurred.
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:
For Females:
- If you're using the foam or aerosol version that contains 5% minoxidil, apply one capful once a day.
- If you're using the solution version that contains 2% minoxidil, apply 1 milliliter (ml) twice a day.
For Males:
- If you're using the foam or aerosol version that contains 5% minoxidil, apply one capful twice a day.
- If you're using the solution version that contains either 2% or 5% minoxidil, apply 1 milliliter (ml) twice a day.
Remember, it's important to use minoxidil consistently for at least 4 months to see if it helps with hair growth.
Use in Children:
Not indicated.
Minoxidil Dose in Pregnancy & lactation
- In animal studies where minoxidil was given by mouth, some negative effects on reproduction were seen.
Minoxidil use during breastfeeding:
- When minoxidil is taken by mouth, it can be found in breast milk.
Dose in Kidney Disease:
- The instructions provided by the manufacturer don't include any specific changes in dosage for people with kidney problems.
Dose in Liver disease:
- The manufacturer's instructions don't mention any dosage adjustments for individuals with liver issues.
Side Effects of Minoxidil (Rogaine, Hairmax):
- Dermatologic:
- Local erythema
- Pruritus
- Systemic Side effects:
- Hypotension
- Postural dizziness.
Contraindications to Minoxidil (Rogaine, Hairmax):
- When using minoxidil without a prescription, it's important to follow the product labeling strictly.
- Don't use it if your hair loss differs from what's described on the label, if you have no family history of hair loss, if your hair loss happens suddenly or in patches, if it's linked to childbirth, if you're unsure why you're losing hair, if you're under 18 years old, if your scalp is red, inflamed, infected, irritated, or painful, or if you're using other scalp medications.
- Also, don't use products labeled for men on women.
Warnings and precautions
Color changes for hair:
- Minoxidil might cause changes in your hair color or texture.
Heart disease
- If you have heart disease, you need to be careful when using minoxidil.
- Minoxidil can be absorbed into your body, which might affect your fluids and electrolytes.
- Before using minoxidil on your skin, it's essential to weigh the potential risks and benefits, especially if you have heart problems.
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 Application:
- Apply minoxidil only on your scalp; don't use it on other body parts.
- Put it directly on the areas where your hair is thinning.
- Massage it into your scalp using your fingers.
- After applying, remember to wash your hands.
- For more instructions, check the information provided by the manufacturer.
Foam Application:
- The foam may start to melt when it touches warm fingers.
- Before using it, rinse your fingers with cold water and make sure they are completely dry.
- Then, apply the foam to your scalp as directed.
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 |
Minoxidil is a medication primarily used for the treatment of hair loss. It's available in various forms, including topical solutions and foams, and it's typically applied directly to the scalp. Originally, minoxidil was developed as an oral medication for high blood pressure, but researchers discovered its hair growth side effect during clinical trials.
The exact mechanism of how minoxidil stimulates hair growth isn't fully understood, but it's believed to prolong the anagen (growth) phase of the hair follicle cycle and increase blood flow to the scalp. This results in improved hair follicle function and, in some cases, the regrowth of hair in areas where it has been lost or thinning has occurred.
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:
For Females:
- If you're using the foam or aerosol version that contains 5% minoxidil, apply one capful once a day.
- If you're using the solution version that contains 2% minoxidil, apply 1 milliliter (ml) twice a day.
For Males:
- If you're using the foam or aerosol version that contains 5% minoxidil, apply one capful twice a day.
- If you're using the solution version that contains either 2% or 5% minoxidil, apply 1 milliliter (ml) twice a day.
Remember, it's important to use minoxidil consistently for at least 4 months to see if it helps with hair growth.
Use in Children:
Not indicated.
Minoxidil Dose in Pregnancy & lactation
- In animal studies where minoxidil was given by mouth, some negative effects on reproduction were seen.
Minoxidil use during breastfeeding:
- When minoxidil is taken by mouth, it can be found in breast milk.
Dose in Kidney Disease:
- The instructions provided by the manufacturer don't include any specific changes in dosage for people with kidney problems.
Dose in Liver disease:
- The manufacturer's instructions don't mention any dosage adjustments for individuals with liver issues.
Side Effects of Minoxidil (Rogaine, Hairmax):
- Dermatologic:
- Local erythema
- Pruritus
- Systemic Side effects:
- Hypotension
- Postural dizziness.
Contraindications to Minoxidil (Rogaine, Hairmax):
- When using minoxidil without a prescription, it's important to follow the product labeling strictly.
- Don't use it if your hair loss differs from what's described on the label, if you have no family history of hair loss, if your hair loss happens suddenly or in patches, if it's linked to childbirth, if you're unsure why you're losing hair, if you're under 18 years old, if your scalp is red, inflamed, infected, irritated, or painful, or if you're using other scalp medications.
- Also, don't use products labeled for men on women.
Warnings and precautions
Color changes for hair:
- Minoxidil might cause changes in your hair color or texture.
Heart disease
- If you have heart disease, you need to be careful when using minoxidil.
- Minoxidil can be absorbed into your body, which might affect your fluids and electrolytes.
- Before using minoxidil on your skin, it's essential to weigh the potential risks and benefits, especially if you have heart problems.
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 Application:
- Apply minoxidil only on your scalp; don't use it on other body parts.
- Put it directly on the areas where your hair is thinning.
- Massage it into your scalp using your fingers.
- After applying, remember to wash your hands.
- For more instructions, check the information provided by the manufacturer.
Foam Application:
- The foam may start to melt when it touches warm fingers.
- Before using it, rinse your fingers with cold water and make sure they are completely dry.
- Then, apply the foam to your scalp as directed.
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 |
