Minoxidil

Minoxidil, sold under the brand names Loniten and Rogaine among others, is a medication used for the treatment of high blood pressure and hair loss. It may also be used off-label to promote beard growth and treat nail problems. The drug promotes hair growth, but its effects are fully reversible and it does not slow or prevent hair loss. It is available as a generic medication by prescription in oral tablet form and over-the-counter as a topical liquid or foam. Oral minoxidil is used at high doses to treat high blood pressure and at low doses to treat hair loss, while topical minoxidil is used exclusively for hair loss and related indications. Extended-release oral minoxidil and sublingual minoxidil formulations for hair loss are also being studied and developed. Side effects of oral minoxidil may include low blood pressure, water retention and edema, salt retention, rapid heartbeat, dizziness, lightheadedness, excessive hair growth, and temporary hair shedding, among others. Adverse effects of topical minoxidil include skin irritation, itching, dandruff, and temporary hair shedding, among others. Rare but serious adverse effects of oral minoxidil include pericardial effusion, pleural effusion, cardiac tamponade, other cardiovascular complications, and pseudoacromegaly, among others. Minoxidil is a prodrug of minoxidil sulfate, which acts as a KATP potassium channel opener to widen blood vessels and increase hair growth. The effects of minoxidil are dose-dependently similar to the symptoms of Cantú syndrome. Minoxidil was discovered in 1963 and was introduced for treatment of high blood pressure in 1979. It was unexpectedly found to cause hair growth in 1971, resulting in it being repurposed for treatment of hair loss and approved in topical form for this use in 1988. Topical minoxidil became available over-the-counter in 1996. Low-dose oral minoxidil (LDOM) emerged for treatment of hair loss in 2015 and dramatically increased in popularity starting in 2022. Extended-release oral minoxidil and sublingual minoxidil were developed in the 2020s for hair loss and are in late-stage trials. Aside from its use in humans, minoxidil is extremely toxic to cats and dogs even in small amounts.

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