II. Indications

III. Preparations

  1. Regular Strength 2%
    1. Cost to pharmacist
      1. Brand Name: $25/month, $300/year
      2. Generic: $13/month, $156/year
  2. Extra Strength 5%
    1. Cost to pharmacist: $30/month, $360/year
    2. Not more effective than 2% in Androgenetic Alopecia
    3. Indicated as adjunct in Alopecia Areata
    4. Higher Incidence of facial Hypertrichosis

IV. Mechanism

  1. Increases Hair Shaft epithelial cell growth
  2. Potentiated by Retin A
  3. Direct effect on Hair Follicle
    1. Activates Hair Follicles in Catagen
    2. Extends Anagen duration
    3. Expands Hair Follicles
  4. Decreases hair shedding

V. Dosing

  1. Apply bid to dry scalp
    1. Spray 6 times (1 ml) or
    2. Dropper bottle
  2. Wash hands carefully after applying
    1. Reduces risk of spread to face and Hypertrichosis

VI. Advantages

  1. Appropriate for both men and women
  2. Modestly effective
  3. Most effective for vertex baldness
    1. Vertex baldness under 5 years
    2. Hair Loss under 10 cm (4 inch) diameter

VII. Disadvantages

  1. Less effective for frontal Hair Loss
  2. New hair lost when treatment discontinued

VIII. Adverse effects

  1. Hypertrichosis (excessive facial hair)
    1. Resolves by one year even if Minoxidil continued
    2. Bleach more evident darker hairs
  2. Pruritus of scalp
  3. Allergic Reaction (usually to propylene glycol)
    1. Compounding pharmacist can use alternative base

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Cost: Medications

minoxidil (on 5/18/2016 at Medicaid.Gov Survey of pharmacy drug pricing)
MINOXIDIL 10 MG TABLET Generic $0.24 each
MINOXIDIL 2% SOLUTION Generic OTC $0.09 per ml
MINOXIDIL 2.5 MG TABLET Generic $0.13 each
MINOXIDIL 5% SOLUTION Generic OTC $0.14 per ml

Ontology: Minoxidil (C0026196)

Definition (NCI) An orally administered vasodilator with hair growth stimulatory and antihypertensive effects. Minoxidil is converted into its active metabolite minoxidil sulphate by sulphotransferase enzymes. Minoxidil sulphate exerts its antihypertensive effect by opening of plasma membrane adenosine triphosphate (ATP)-sensitive potassium channels (KATP channels), thereby directly and rapidly relaxing arteriolar smooth muscle and subsequent reduction of elevated systolic and diastolic blood pressure by decreasing peripheral vascular resistance. This agent's hair growth stimulatory effect may be mediated through its vasodilatory activity, thereby increasing cutaneous blood flow, or due to its direct stimulatory effect on hair follicle cells and forcing them from their resting phase into their active growth phase.
Definition (MSH) A potent direct-acting peripheral vasodilator (VASODILATOR AGENTS) that reduces peripheral resistance and produces a fall in BLOOD PRESSURE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p371)
Definition (CSP) potent long acting orally effective vasodilator, acting mainly on arterioles, used as an antihypertensive; also applied topically in the treatment of male pattern baldness of the vertex.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008914
SnomedCT 332754004, 387272001, 49577002
LNC LP19149-1, MTHU007401
English Minoxidil, 2,4-Pyrimidinediamine, 6-(1-piperidinyl)-, 3-oxide, Minoxidil [androgen alopecia], 2,3-Dihydro-3-hydroxy-2-imino-6-(1-piperidinyl)-4-pyrimidinamine, 2,4-Pyrimidinediamine, 6-(1-Piperidinyl)-, 3-Oxide, minoxidil, minoxidil (medication), MINOXIDIL, Minoxidil [Chemical/Ingredient], minoxidil products, Minoxidil [androgen alopecia] (product), Minoxidil (product), Minoxidil (substance), Minoxidil [androgen alopecia] (substance)
Swedish Minoxidil
Czech minoxidil
Finnish Minoksidiili
Russian MINOKSIDIL, МИНОКСИДИЛ
Japanese ミノキシジル, ロニテン, リアップ
Polish Minoksydyl
Spanish minoxidil (alopecia androgénica), minoxidil (alopecia androgénica) (producto), minoxidil (producto), minoxidil (sustancia), minoxidilo, minoxidil, Minoxidil
French Minoxidil
German Minoxidil
Italian Minoxidil
Portuguese Minoxidil

Ontology: Rogaine (C0730881)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008914
English topical minoxidil (Rogaine), regaine, rogaine, Rogaine, Regaine, Minoxidil Pfizer Brand, Pfizer Brand of Minoxidil