It is used as a topical spray for the treatment of alopecia androgenetica of the scalp.
Note: Avoid in patients prone to develop 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 and postural dizziness.
Minoxidil (Rogaine, Hairmax) Dose in the treatment of Alopecia: Topical:
Note: Continuous treatment for four months or more may be necessary for hair growth.
Females:
Foam, aerosol 5%:
Apply a half capful once a day.
Solution 2%:
Apply 1 mL two times a day.
Males:
Foam, aerosol 5%:
Apply a half capful two times a day.
Solution 2% or 5%:
Apply 1 mL two times a day.
Use in Children:
Not indicated.
Pregnancy Risk Category: C
It belongs to the second-generation antihistamines.It is a selective inhibitor of peripheral histamine (H-1) receptors and platelet-activating factor (PAF) with a long half-life.
It also inhibits the release of cytokines (particularly the TNF-alpha in human mast cells and monocytes) and the degranulation of mast cells when administered in higher doses.
Onset:
1 to 2 hours
Dose in Kidney Disease:
There are no dosage adjustments provided in the manufacturer’s labeling
Dose in Liver disease:
There are no dosage adjustments provided in the manufacturer’s labeling
Side Effects of Minoxidil (Rogaine, Hairmax):
Dermatologic:
Local erythema
Pruritus
Systemic Side effects:
Hypotension
Postural dizziness.
Contraindications to Minoxidil (Rogaine, Hairmax):
OTC labeling should not be used in self-medication situations.
If the degree of hair fall is greater than the one stated in the product labeling.
Individuals who experience sudden hair loss, or patchy hair loss.
Individuals without a history of hair loss in their family;
Hair loss during pregnancy and childbirth is common
Individuals who have a diagnosed scalp disorder.
Children 18 years old and younger.
If your scalp is reddened, itchy, inflamed or infected, consult your doctor immediately.
Concomitant use of topical scalp medication.
Women should not use products for men.
Warnings and precautions
Color changes for hair:
Hair color and texture may change as a result of treatment.
Heart disease
Systemic absorption can occur, which could lead to hypotension, fluid or electrolyte changes.Patients with heart disease should not use it.
Monitoring Parameters:
Monitor blood pressure in patients with hypertension, those on concomitant blood pressure-lowering medications, and patients with underlying heart diseases.
How to administer Minoxidil (Rogaine, Hairmax)?
Topical:
It is intended for topical use over the scalp only. Avoid using it on other parts of the body. It should be applied directly to the hair-thinning areas of the scalp and massage into the scalp with fingers. The hands should be washed after applying the medicine. Let the solution dry.
Also, read the manufacturer’s labeling for details.
Foam:
The foam may melt when in contact with warm fingers. Rinse fingers in cold water and dry before using it.
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 stimulate the hair follicles that are in the resting state.
