Formulary
Minoxidil: Indications, Dosing, Side Effects and Interactions
Minoxidil clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Minoxidil: Indications, Dosing, Side Effects and Interactions
Minoxidil clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Severe hypertension, in addition to a diuretic and a beta-blocker**
- **Adult** (By Mouth): Initially 5 mg daily in 1-2 divided doses, then increased in steps of 5-10 mg, increased at intervals of at least 3 days; maximum 100 mg per day.
- **Elderly** (By Mouth): Initially 2.5 mg daily in 1-2 divided doses, then increased in steps of 5-10 mg, increased at intervals of at least 3 days; maximum 100 mg per day.
**Androgenetic alopecia**
- **Adult** (To The Skin): Apply 1 mL twice daily, to be applied to the affected areas of scalp; discontinue if no improvement after 1 year.
**Severe hypertension for minoxidil**
- **Child 1 month-11 years** (By mouth): Initially 200 micrograms/kg daily in 1-2 divided doses, then increased in steps of 100-200 micrograms/kg, increased at intervals of at least 3 days; maximum 1 mg/kg per day.
- **Child 12-17 years** (By mouth): Initially 5 mg daily in 1-2 divided doses, then increased in steps of 5-10 mg daily, increased at intervals of at least 3 days; maximum 100 mg per day.
Cautions
With systemic use Acute porphyrias ; after myocardial infarction (until stabilised); angina With topical use Avoid contact with broken, infected, shaved, or inflamed skin; avoid contact with eyes; avoid contact with mouth; avoid contact with mucous membranes; avoid inhalation of spray mist; avoid occlusive dressings
Contraindications
Phaeochromocytoma
Side effects
General side-effects: Common or very common Hair changes Specific side-effects: Common or very common With oral use Fluid retention; oedema; pericardial disorders; pericarditis; tachycardia Uncommon With topical use Hypotension Rare or very rare With oral use Leucopenia; skin reactions; Stevens-Johnson syndrome; thrombocytopenia Frequency not known With oral use Angina pectoris; breast tenderness; gastrointestinal disorder; pleural effusion; sodium retention; weight increased Side-effects, further information When used topically systemic effects unlikely; only about 1-2% absorbed (greater absorption may occur with use on inflamed skin).
Interactions
**Other interactions (4):**
- The effect of minoxidil may be additive to concurrent antihypertensive agents and other agents with blood pressure lowering effects.
- The interaction of minoxidil with sympathetic-blocking agents such as guanethidine or betanidine may produce excessive blood pressure reduction and/or orthostatic hypotension.
- If possible guanethidine should be discontinued well before minoxidil is begun.
- If this is not feasible, minoxidil therapy should be instituted in the hospital and the patient monitored carefully for orthostatic events.
Pregnancy
Avoid-possible toxicity including reduced placental perfusion. Neonatal hirsutism reported.
Breast feeding
Present in milk but not known to be harmful.
Renal impairment
With oral use: Caution in significant impairment. M Dose adjustments With oral use: Smaller doses may be required in renal failure. M
Medicinal forms
Tablet,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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