Minoxidil

About Minoxidil

Minoxidil tablets are a vasodilator that lowers blood pressure by relaxing blood vessels. Because of the potential for serious adverse effects, they are labeled only for high blood pressure that causes symptoms or organ damage and is not controlled by maximum doses of a diuretic plus two other blood pressure medicines. People over 12 start at 5 mg once a day, raised at least three days apart, usually to 10 to 40 mg a day in one or two doses, with a maximum of 100 mg; children under 12 start at 0.2 mg per kg, up to 50 mg a day. The topical products are for hair loss that runs in the family: for men, the 5 percent solution and 5 percent foam regrow hair on the top of the scalp, not a receding hairline, and are used twice a day; for women, the 2 percent solution is used twice a day and the 5 percent foam once a day. None is for anyone under 18.

The tablets’ boxed warning says minoxidil can cause pericardial effusion (fluid around the heart), occasionally progressing to tamponade, and can worsen angina. It is given under close supervision, usually with a beta blocker to prevent a fast heart rate and a diuretic, often a loop diuretic, to prevent serious fluid buildup; people with malignant hypertension or taking guanethidine start it in hospital. It must not be used with pheochromocytoma. Elongation, thickening and darkening of fine body hair develops in most people within three to six weeks, usually first on the face, and can take one to six months after stopping to return to its earlier appearance; the label notes it is especially disturbing to children and women but says not to stop the tablets without the prescriber. People with kidney failure or on dialysis may need smaller doses.

Hair growth is a side effect of the tablets, not a labeled use: neither the tablet label nor MedlinePlus lists hair loss among the uses of oral minoxidil. People on the tablets weigh themselves daily and call about rapid weight gain, swelling or puffiness of the face, hands, ankles or stomach, or a pulse 20 or more beats a minute above normal. In pregnancy the tablets are used only if the benefit justifies the risk, and they should not be taken while breastfeeding. The topical labels say they may be harmful in pregnancy or breastfeeding and to stop and ask a doctor if chest pain, a rapid heartbeat, faintness or dizziness occurs; hair loss begins again when they are stopped.

Taking Minoxidil

How to take it

Tablets once or twice a day as prescribed, with the other blood pressure medicines prescribed alongside them. Apply topical solution or foam only to a dry scalp in the hair loss area, as often as the package directs, then wash your hands; using more will not improve results.

If you miss a dose

Tablets: take it as soon as you remember, unless the next dose is almost due, and never take a double dose. Topical: skip the missed application.

Storage

At room temperature, away from heat and moisture and out of reach of children. Keep the topical products away from fire and flame, and do not store the foam above 120°F (49°C).

Interactions to know about

With the tablets, guanethidine can cause profound drops in blood pressure on standing, so it is stopped well before minoxidil when possible. Do not use other medicines on the scalp with topical minoxidil, and ask a doctor first if you have heart disease.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Minoxidil differs from pharmacy to pharmacy

Generic minoxidil tablets in both strengths come from more than one maker, but each pharmacy sets its own cash price, including its dispensing fee, so quotes for the same tablet can differ. The beta blocker and diuretic taken with the tablets are separate prescriptions, each quoted on its own.

The topical solution and foam are bought over the counter without a prescription, and FDA-approved generic solutions and foams are sold alongside Rogaine.

Ways to pay less for Minoxidil without insurance

• For tablets, ask whether minoxidil is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Once your dose is stable, ask for a ninety-day supply, and refill the beta blocker and diuretic at the same time.
• For the over-the-counter topical products, compare an FDA-approved generic or store-brand product with Rogaine of the same strength and form, labeled for men or for women.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Minoxidil

1. 1.Which signs of fluid buildup or a fast pulse mean I should call right away?
2. 2.How should I take my minoxidil with my beta blocker and diuretic?
3. 3.How long will the extra body hair from the tablets last if my treatment changes?
4. 4.Which over-the-counter strength and form fit my hair loss, and is it safe with my heart condition?

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