minoxidil
Minoxidil helps treat high blood pressure (hypertension) in adults and children by relaxing the blood vessels. It's typically used only when you have extremely high blood pressure, when you have symptoms, and when other medications haven't worked to control your blood pressure. Minoxidil tablets are only for these situations because the medication has side effects and risks, like swelling of the body, fast heart rate, and other heart problems that can be potentially serious.
What is Minoxidil?
What is Minoxidil used for?
How Minoxidil works
Minoxidil is a vasodilator. It relaxes your blood vessels so that blood can flow through the body more easily. This helps lower your blood pressure.
Drug Facts
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What are the side effects of Minoxidil?
Common Side Effects
- Swelling in the body due to fluid buildup
- Body hair growth that's more than usual
- Faster heart rate
Other Side Effects
- Nausea
- Vomiting
- Skin rash
- Breast tenderness
Serious Side Effects
- Serious skin reaction: rash, hives, peeling or blistering skin, flu-like symptoms
- Fluid buildup in the body: rapid weight gain of more than 5 pounds, trouble breathing (especially when lying down)
- Heart problems: chest pain, shortness of breath, dizziness
- Faster heart rate: Heart rate that's more than 20 beats per minute (bpm) higher than it usually is
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Less common
Itching or skin rash (continued)
Rare
Acne at site of application
burning of scalp
facial hair growth
increased hair loss
inflammation or soreness at root of hair
reddened skin
swelling of face
Signs and symptoms of too much medicine being absorbed into the body—Rare
Blurred vision or other changes in vision
dizziness
fainting
fast or irregular heartbeat
flushing
headache
lightheadedness
numbness or tingling of hands, feet, or face
swelling of face, hands, feet, or lower legs
weight gain (rapid)
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Minoxidil
Pros
Can help control blood pressure when it's extremely high or when other medications haven't worked
Can take with or without food
Available as a lower-cost generic medication
Cons
Not usually the first choice for treating high blood pressure
Usually must take additional medications to prevent side effects (a water pill and a beta-blocker)
Can cause unusual body hair growth, which can be unpleasant
Pharmacist tips for Minoxidil
Even if you're feeling okay, be sure to take minoxidil at the same time every day to help the medication work as well as it can. Don't suddenly stop the medication without talking to your provider to prevent your blood pressure from getting too high again.
If you miss or forget to take a dose, skip the missed dose. Wait until it's time to take your next dose and then continue taking minoxidil as you usually do.
Your body hair might get longer, thicker, and darker within 3 to 6 weeks of starting minoxidil. You'll typically notice this on your face first, but it can happen later on your back, arms, and legs. This unusual hair growth should stop when you stop taking minoxidil, but it can take up to 6 months to go back to how you used to look. Talk to your provider if you're concerned about this side effect.
Your provider will prescribe two other medications for you to take with minoxidil to help manage the medication's side effects and risks. A loop diuretic (“water pill”) helps lessen risks like swelling and heart failure, a beta-blocker helps prevent fast heart rate.
Ask your provider about how often you should check your blood pressure and heart rate while you're taking minoxidil. This helps track how you're responding to the medication and monitor for side effects (fast heart rate). Contact your provider if your blood pressure gets very high or if your heart rate is more than 20 beats per minute (bpm) higher than it usually is.
Your provider might suggest that you follow a low-sodium diet. This not only helps lower blood pressure, but it also helps manage salt and fluid retention in the body and your risk for heart failure from minoxidil use.
Frequently asked questions about Minoxidil
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What are the risks and warnings for Minoxidil?
Minoxidil can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Fast heart rate and chest pain
Minoxidil can cause your heart rate to go up. As a result, you might also have new or worsened chest pain when you take the medication. To prevent fast heart rate and chest pain, you'll probably need to take a beta-blocker in addition to minoxidil.
Serious heart problems
Some people who took minoxidil had serious heart problems, such as pericarditis (swelling of the lining around the heart) and pericardial effusion (too much fluid buildup around the heart). Pericardial effusion can sometimes lead to cardiac tamponade (too much pressure and stress on the heart), which can be life-threatening.
While there might be several causes for these heart problems, it's important for your provider to check for them while you take minoxidil as a precaution. Get medical help right away if you have symptoms such as chest pain, shortness of breath, swelling of the legs, trouble doing light exercise like walking, and dizziness.
Salt and fluid buildup in the body (risk for swelling and heart failure)
Risk factors: Heart failure
Minoxidil can cause your body to hold onto salt and water. This can lead to swelling in the body, especially in your legs, ankles, and feet and sometimes in your arms and hands. Salt and water retention in the body can also raise your risk for heart failure (a condition where the heart doesn’t pump blood well).
Your provider will probably prescribe a loop diuretic (“water pill”) for you to take in addition to minoxidil to lessen swelling and your risk for heart failure. Your provider might also tell you to follow a low-sodium diet to help. Call your provider if you gain more than 5 pounds quickly, have trouble breathing, or have uncomfortable swelling in the ankles or feet. These can be signs of fluid buildup or heart failure.
Harmful effects from lowering blood pressure too quickly
When people with very high blood pressure get treated with medications to help control blood pressure, their blood pressure can drop too quickly. This can affect how much blood flows to certain parts of the body and lead to harmful effects, like fainting, stroke, heart attack, and loss of vision or hearing. To be safe, treatment with minoxidil should be started in a hospital for people with extremely high blood pressure. This allows providers to check that blood pressure is being lowered safely.
Minoxidil dosage forms
Typical dosing for Minoxidil
Adults and children over 12 years of age:
The typical starting dose is 5 mg by mouth once a day, with or without food. Your provider will adjust your dose based on how well the medication is controlling your blood pressure.
Most people end up taking between 10 mg and 40 mg per day, either as a single dose or as smaller doses throughout the day.
The maximum dose is 100 mg per day.
Children under 12 years of age:
The typical starting dose is 0.2 mg/kg of body weight by mouth once a day, with or without food. Your child's provider will adjust the dose based on how well the medication is working to lower blood pressure.
Most children end up taking between 0.25 mg/kg and 1 mg/kg per day, either as a single dose or as smaller doses during the day.
The maximum dose is 50 mg per day.
More on Minoxidil dosage forms
Interactions between Minoxidil and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
How much does Minoxidil cost?
Minoxidil contraindications
Pheochromocytoma (a rare type of tumor in the adrenal glands)
What are alternatives to Minoxidil?
Chest pain (angina)
Lower risk of death after heart attack
What is the latest news about Minoxidil?
Minoxidil images
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References
Best studies we foundActavis Pharma, Inc. (2021). Minoxidil tablet [package insert]. DailyMed.
Bennion, S. D., (1982). Chest Pain and Abnormal Electrocardiogram Associated With Minoxidil. Military Medicine.
Borges do Nascimento, I. J., et al. (2020). Effect of oral minoxidil for alopecia: Systematic review. International Journal of Trichology.
MedlinePlus. (2022). Cardiac tamponade.
MedlinePlus. (2022). Pericarditis.
National Cancer Institute. (2020). Pheochromocytoma.
ScienceDirect. (n.d.). Minoxidil.
Sica, D. A., et al. (2007). Minoxidil: An underused vasodilator for resistant or severe hypertension. The Journal of Clinical Hypertension.
Whelton, P. K., et al. (2017). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension.
Wilburn, R. L., et al. (1975). Long-term treatment of severe hypertension with minoxidil, propranolol and furosemide. Circulation.
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