Important safety information
What you should know before taking oral minoxidil.
Oral Minoxidil
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What is oral minoxidil?
Minoxidil is the active ingredient in Rogaine, a popular over-the-counter hair loss treatment spray. The same active ingredient can be taken by mouth in pill form as a convenient once-a-day hair loss treatment.
While topical minoxidil is FDA-approved to treat hair loss and is available without a prescription, oral minoxidil is considered off-label and requires a prescription. Healthcare providers have the discretion to prescribe a medication off-label if they believe it’s an appropriate course of treatment for a particular patient. Learn more about off-label treatment here.
How does oral minoxidil work?
Exactly how minoxidil works isn't fully understood, but the medication is believed to work by extending the growth phase of hair follicles and increasing the size of hair follicles, potentially promoting hair regrowth.
Minoxidil is also believed to relax blood vessels, causing them to widen and increase blood flow. This may be one of the ways that minoxidil works to stop or slow hair loss and, in some cases, even regrow hair.
Who is oral minoxidil for?
Oral minoxidil is for people experiencing androgenetic alopecia, also known as male pattern baldness. While there are many different treatments available, many patients find taking one oral minoxidil pill a day easier than. applying a topical treatment twice a day. A simpler routine can be easier to stick to, which can support better results.
Another reason patients may opt for oral minoxidil is to avoid the (slight) risk of sexual side effects from taking finasteride.
While a patient’s preference is always considered, providers will ultimately make treatment recommendations based on the individual’s medical history, along with the contraindications and side effects associated with oral minoxidil.
Common side effects
Side effects may include low blood pressure and leg swelling.
The most common side effect is hypertrichosis (additional hair growth on the face or body). Read through the full Important Safety Information (including a boxed warning)
Oral minoxidil may cause serious side effects that impact the heart, including pericardial effusion and tamponade. When tested on animals, minoxidil caused lesions of the heart as well as other adverse heart effects. See Important Safety Information and Warnings.
of clinical trial participants in a study exploring oral minoxidil saw elongation, thickening and enhanced pigmentation of their hair.
In clinical trials studying higher doses of oral minoxidil for high blood pressure, patients noticed an unexpected effect: hair growth. Oral minoxidil is FDA-approved at higher doses to treat high blood pressure, but because of those clinical trials, doctors began prescribing low-dose oral minoxidil tablets off-label as a convenient, once-a-day hair loss treatment.
Common questions
What should I expect when taking oral minoxidil?
Early results may be seen within a few months, but it could take longer to see the full effects
You may experience shedding during the first few weeks of treatment. This is normal and shouldn’t cause you to worry. Extra shedding will resolve as the new hair grows in (usually in about a month)
If you do not see improvement after 6 months of consistent use, you can message your provider to discuss adjusting your treatment plan
What are the most common side effects of oral minoxidil?
Common side effects can include low blood pressure (hypotension) and swelling in the legs (edema), among others. Some people experience headaches, although those typically improve over time. Others may experience additional hair growth on the face or body (hypertrichosis). This is the most common side effect of taking oral minoxidil, though the complaint is more common among women than men and is also more common when taking over 5 mg per day.
Side effects of oral minoxidil may be more pronounced when the drug is prescribed at higher doses. For full safety information (including the boxed warning) read through the Important Safety Information here.
What’s the difference between oral finasteride and oral minoxidil?
Oral finasteride is an FDA-approved prescription hair loss treatment, while oral minoxidil is considered an off-label prescription for hair loss. This means oral minoxidil is not FDA-approved for that particular use, but a provider can still prescribe it if they deem it safe and appropriate for the patient.
Oral minoxidil may be preferred by men who do not want to risk the known slight chance of sexual side effects from taking finasteride. Oral minoxidil and oral finasteride have different mechanisms of action to tackle hair loss. Your provider will recommend a treatment based on your medical history, lifestyle, and any particular treatment preferences or side effect aversions you may have.
What’s the difference between topical minoxidil and oral minoxidil?
Topical minoxidil is an FDA-approved hair loss treatment that does not require a prescription whereas oral minoxidil is considered an off-label prescription for hair loss and does require a prescription. “Off-label” means it’s not FDA-approved for that particular use, but can still be prescribed at the provider’s discretion.
Topical and oral minoxidil contain the same active ingredient. While there have not been clinical studies comparing their efficacy, there appear to be some benefits of using an oral treatment method vs. a topical treatment method, such as more precise dosing and better treatment adherence & consistency.
Some people may also benefit less from topical minoxidil due to lower levels of a specific enzyme in their hair follicles (follicular sulfotransferase). Oral minoxidil may be an effective alternative in this case, as the medication is absorbed systemically and is thought to be activated by the liver.
Some people may get results from topical minoxidil but still want to consider oral minoxidil due to negative experiences with the topical such as scalp irritation, treatment running down your neck before you can rub it in, or the hassle of applying treatment two times a day.
Using both topical minoxidil and oral minoxidil at the same time will not produce better results and therefore, is not recommended.
How should I take oral minoxidil?
You may take oral minoxidil with or without food
Consistent daily treatment is key to success, but oral minoxidil will not work better or faster if you take it more than once a day
Oral minoxidil should be kept dry and at room temperature (between 68 and 77 degrees F) in the packaging provided by the pharmacy. Please keep it away from children and pets.
