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Direct vasodilator / hair-growth stimulator

Minoxidil

Brand names: Loniten, Regaine (topical)

Adult dose

Dose: Severe hypertension: 5mg OD-BD initial, increase by 5–10mg every 3 days; max 100mg/day. Topical 2–5% solution: apply BD to scalp
Route: PO/Topical
Frequency: OD-BD

Clinical pearls

  • Severe resistant hypertension only — co-prescribe with diuretic + β-blocker
  • Topical minoxidil for androgenetic alopecia

Contraindications

  • Phaeochromocytoma
  • Recent MI
  • Aortic dissection
  • Pregnancy
  • Hypersensitivity

Side effects

  • Marked fluid retention/oedema
  • Reflex tachycardia
  • Hypertrichosis (everywhere — may be cosmetic problem in women)
  • Pericardial effusion
  • ECG changes

Interactions

  • Other antihypertensives (additive)
  • Guanethidine

Monitoring

  • BP
  • HR
  • Weight
  • Echo if cardiac symptoms

Reference: BNF; https://bnf.nice.org.uk/drugs/minoxidil/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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