Indications |
Oral Severe hypertension unresponsive to standard therapy Adult: In conjunction with a β-blocker or methyldopa, and a diuretic: Initially, 2.5-5 mg daily; gradually increase at intervals of at least 3 days to 40 or 50 mg daily depending on response. Max: 100 mg daily. Give daily dose in 1-2 divided doses. For a more rapid control of BP: Dose changes may be made every 6 hr with careful monitoring. Child: In conjunction with a β-blocker or methyldopa, and a diuretic: <12 yr: Initially, 100-200 mcg/kg daily; increase in increments of 100-200 mcg/kg at intervals of at least 3 days, until BP is controlled. Max: 1 mg/kg or 50 mg daily. Elderly: In conjunction with a β-blocker or methyldopa, and a diuretic: Initially, 2.5 mg daily; increase gradually. Renal impairment: Initiate at smaller doses or at longer dosage intervals. Topical/Cutaneous Male pattern baldness Adult: Apply 1 ml of a 2% or 5% solution to the scalp bid. 4 mth of treatment may be necessary. |
Contraindications |
Pheochromocytoma, acute MI, dissecting aortic aneurysm. |
Warnings / Precautions |
Significant renal dysfunction; coronary artery disease; recent MI; pulmonary hypertension; angina pectoris; chronic CHF; porphyria. Monitor fluid and electrolyte balance, body wt. Restrict topical application to the scalp. Pregnancy. |
Adverse Reactions |
Reflex tachycardia, fluid retention (accompanied by wt gain, oedema, and sometimes deterioration of existing heart failure and changes in the ECG), hypertrichosis. Headache, nausea, gynaecomastia and breast tenderness, polymenorrhoea, skin rash, thrombocytopenia. Topical: Systemic effects may also occur; contact dermatitis, pruritus, local burning, flushing; changes in hair colour or texture. Potentially Fatal: Ischaemic heart disease; pericardial effusion progressing to tamponade and death; angina pectoris may be aggravated or uncovered; pulmonary hypertension. Rebound hypertension (in patients with severe hypertension). Stevens-Johnson syndrome. |
Overdose Reactions |
Symptoms: Hypotension, tachycardia, headache, nausea, dizziness, weakness syncope, warm flushed skin and palpitations; lethargy and ataxia (in children). Management: Trendelenburg positioning, vasoconstrictor or IV fluids may be used for hypotension; treatment is mainly supportive and symptomatic. |
Drug Interactions |
Antihypertensive effect may be enhanced by other hypotensive drugs. Topical: Absorption may be increased with corticosteroids, retinoids, occlusive ointment bases. Potentially Fatal: Severe orthostatic hypotension may occur with guanethidine. See Below for More minoxidil Drug Interactions |
Food Interactions |
Avoid natural licorice as it may aggravate fluid retention. |
Mechanism of Actions |
Minoxidil is an antihypertensive with direct vasodilating property. It reduces elevated BP accompanied by reflex tachycardia, increased cardiac output and elevated plasma renin. Applied topically, minoxidil stimulates hair growth secondary to vasodilation, increases cutaneous blood flow and stimulates resting hair follicles. Onset: Oral: Approx 30 min. Max effect in 2-3 hr. Duration: Oral: 2-5 days. Absorption: 90% absorbed from the GI tract (oral); 0.3-4.5% from intact scalp (topical). Distribution: Enters breast milk. Metabolism: Extensively hepatic via glucuronidation. Excretion: Via urine (as metabolites); 3.5-4.2 hr (elimination half-life). |
Administration |
May be taken with or without food. |
Storage Conditions |
Oral: Store at 20-25°C (68-77°F). Topical/Cutaneous: Store at 20-25°C (68-77°F). |
ATC Classification |
C02DC01 - minoxidil ; Belongs to the class of pyrimidine derivative agents acting on arteriolar smooth muscle. Used in the treatment of hypertension. D11AX01 - minoxidil ; Belongs to the class of other dermatologicals. |
Storage |
Oral: Store at 20-25°C (68-77°F). Topical/Cutaneous: Store at 20-25°C (68-77°F). |
Available As |
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Minoxidil
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Minoxidil Containing Brands
Minoxidil is used in following diseases
Drug - Drug Interactions of Minoxidil
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