Minoxidil oral

FDA label

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Titration At least 3 days between dose adjustments (full response takes ≥3 days); every 6 h only if closely monitored

Renal Undefined

Hepatic Undefined

Adjust doses no more often than every 3 days (or every 6 h if closely monitored)

Instructions

• Give once daily if supine DBP reduced <30 mmHg; divide into two doses if reduced >30 mmHg
• Must co-administer a diuretic (e.g., furosemide) to prevent fluid retention
• Must usually co-administer a beta-blocker (or other sympathetic suppressant, e.g., methyldopa/clonidine) to prevent reflex tachycardia

Contraindications

• Pheochromocytoma (may stimulate catecholamine secretion)

Cautions

• Pericardial effusion, occasionally progressing to tamponade
• Exacerbation of angina pectoris
• Salt and water retention — requires concomitant diuretic
• Reflex tachycardia/↑myocardial workload — requires beta-blocker
• Hypertrichosis
• Too rapid or orthostatic BP reduction (esp. malignant HTN or with guanethidine)

Adverse reactions

• Salt/water retention, edema
• Pericardial effusion
• Hypertrichosis (~80%)
• ECG T-wave changes
• Rash (rare bullous eruptions, TEN, Stevens-Johnson)
• Thrombocytopenia/leukopenia (rare)
• Nausea/vomiting
• Breast tenderness

Pregnancy Category C; use only if benefit justifies risk; neonatal hypertrichosis reported after in-utero exposure

Lactation Undefined