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Minoxidil (systemic): Pediatric drug information

Minoxidil (systemic): Pediatric drug information
2025© UpToDate, Inc. and its affiliates and/or licensors. All Rights Reserved.
For additional information see "Minoxidil (systemic): Drug information" and "Minoxidil (systemic): Patient drug information"

For abbreviations, symbols, and age group definitions show table
ALERT: US Boxed Warning
Cardiac effects:

Minoxidil may produce serious adverse effects. It can cause pericardial effusion, occasionally progressing to tamponade, and it can exacerbate angina pectoris. Reserve for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and 2 other antihypertensive agents.

In experimental animals, minoxidil caused several kinds of myocardial lesions and other adverse cardiac effects.

Appropriate use:

Administer under close supervision, usually concomitantly with therapeutic doses of a beta-adrenergic blocking agent, to prevent tachycardia and increased myocardial workload. Usually, it must be given with a diuretic, frequently one acting in the ascending limb of the loop of Henle to prevent serious fluid accumulation. When first administering minoxidil, hospitalize and monitor patients with malignant hypertension and those already receiving guanethidine to avoid too rapid or large orthostatic decreases in blood pressure.

Brand Names: Canada
  • Loniten
Therapeutic Category
  • Antihypertensive;
  • Vasodilator, Direct-Acting
Dosing: Pediatric
Hypertension

Hypertension (alternate agent):

Acute severe hypertension with significant but not life-threatening symptoms (eg, severe headache, vomiting but no seizures):

Children and Adolescents: Oral: Initial: 0.1 to 0.2 mg/kg/dose; may repeat every 8 to 12 hours; maximum dose: 10 mg/dose (Ref). Note: In situations where rapid blood pressure management required, may increase dose after 6 hours with careful monitoring.

Chronic hypertension:

Note: Recommended for use in refractory hypertension with persistent symptoms or target organ damage despite maximal treatment with a diuretic and 2 antihypertensive agents.

Children <12 years: Oral: Initial: 0.2 mg/kg/dose once daily; maximum initial dose: 5 mg/dose; titrate to effect, may increase daily dose by 50% to 100% (eg, 0.1 to 0.2 mg/kg/day) every 3 days; may need to divide doses 1 to 3 times daily; usual daily dose: 0.25 to 1 mg/kg/day in 1 to 3 divided doses; maximum daily dose: 50 mg/day (Ref). Note: In situations where rapid blood pressure management required, may increase dose after 6 hours with careful monitoring.

Children ≥12 years and Adolescents: Oral: Initial: 5 mg once daily; titrate to effect; may increase every 3 days by doubling daily dose (10 mg/day, 20 mg/day, and then 40 mg/day); may need to divide doses 1 to 3 times daily; usual daily dose: 10 to 40 mg/day in 1 to 3 divided doses; maximum daily dose: 100 mg/day (Ref). Note: In situations where rapid blood pressure management required, may increase dose after 6 hours with careful monitoring.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Altered kidney function: Children and Adolescents: Oral: There are no specific dosage recommendations provided in the manufacturer's labeling; however, the manufacturer suggests that patients with renal failure may require a dosage reduction.

Hemodialysis: Dialyzable. Children and Adolescents: Oral: There are no specific dosage recommendations provided in the manufacturer's labeling; however, the manufacturer suggests that patients receiving dialysis may require a dosage reduction.

Dosing: Liver Impairment: Pediatric

Children and Adolescents: There are no dosage adjustments provided in the manufacturer's labeling; use with caution and titrate gradually (minoxidil AUC increased 50% and its clearance decreased in mildly cirrhotic adult patients (Ref)).

Dosing: Adult

(For additional information see "Minoxidil (systemic): Drug information")

Hypertension

Hypertension (alternative agent) (adjunctive agent):

Note: Before prescribing, consider referral to a clinician with expertise in managing hypertension. Reserve for patients with resistant hypertension who do not respond adequately to an optimized 4-drug regimen, ideally consisting of a thiazide-like diuretic (eg, chlorthalidone) and a mineralocorticoid-receptor antagonist (eg, spironolactone). Use in combination with a beta-blocker to prevent reflex tachycardia. Fluid retention may occur and may require additional diuretic therapy (Ref).

Oral: Initial: 5 mg once daily, increase dose gradually in intervals of ≥3 days; usual effective dose: 10 to 40 mg/day in 1 to 3 divided doses; maximum dose: 100 mg/day in 1 to 3 divided doses. During therapy, if supine diastolic pressure is reduced <30 mm Hg, administer total daily dose once daily; if supine diastolic pressure is reduced >30 mm Hg, administer in divided doses (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

There are no specific dosage recommendations provided in the manufacturer's labeling; however, the manufacturer suggests that patients with renal failure and/or receiving dialysis may require a dosage reduction.

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling; use with caution and titrate gradually (minoxidil AUC increased 50% and its clearance decreased in mildly cirrhotic patients (Ref)).

Adverse Reactions (Significant): Considerations
Fluid retention

Minoxidil is associated with fluid retention and subsequent local and generalized edema, including pitting edema, in adult and pediatric patients (Ref). Patients may experience weight gain due to fluid retention (Ref). Fluid retention is reversible and may be a reason for treatment discontinuation or initiation of diuretic therapy (Ref).

Mechanism: Dose-related (Ref); related to the pharmacologic action (ie, increased sodium and water reabsorption) (Ref).

Onset: Varied. Fluid retention may occur within weeks of treatment initiation (Ref); one trial investigating the use of oral minoxidil for the treatment of hair loss (n=1404) found a mean onset of fluid retention of 60 days (range: 15 to 360 days) (Ref)

Risk factors:

• Heart failure or cardiomyopathy (Ref)

Hypertrichosis

Topical minoxidil is used therapeutically for the treatment of alopecia androgenetica; however, hypertrichosis or hair growth in undesirable locations may occur with use of minoxidil for any indication in both adult and pediatric patients (Ref). Excessive hair growth can occur at any location on the body and may lead to treatment discontinuation (Ref). Hypertrichosis is reversible upon discontinuation (Ref); some patients may tolerate or choose to address unwanted hair growth with hair removal techniques as opposed to discontinuing treatment (Ref).

Mechanism: Dose-related (Ref); related to the pharmacologic action (eg, vasodilation leading to increased cutaneous blood flow and subsequent hair growth (Ref)).

Onset: Intermediate to delayed (Ref); one trial investigating the use of oral minoxidil for the treatment of hair loss (n=1404) found a mean onset of hypertrichosis of 60 days (range: 14 to 450 days) (Ref).

Risk factors:

• Higher doses (eg, >1 mg per day (Ref))

• Use of oral minoxidil as compared to topical minoxidil (Ref)

Orthostatic hypotension

Minoxidil may cause orthostatic hypotension (Ref). Some patients require intervention (eg, increased dietary sodium) or treatment discontinuation due to orthostatic hypotension (Ref).

Mechanism: Dose-related; related to the pharmacologic action (eg, vasodilation)

Onset: Rapid to intermediate; one trial investigating the use of oral minoxidil for the treatment of hair loss (n=1404) found a mean onset of lightheadedness (possibly due to orthostatic hypotension) of 5 days (range: 1 to 20 days) (Ref)

Risk factors:

• Concomitant administration of other antihypertensive agents

Pericardial effusion, pericarditis, and cardiac tamponade

The use of minoxidil can result in pericarditis or pericardial effusion that may progress to cardiac tamponade in adult and pediatric patients (Ref); pericardial effusion is reversible following discontinuation of minoxidil and may recur with reinitiation of therapy (Ref).

Mechanism: Not clearly established. May be non–dose-related (idiosyncratic) (Ref) or dose-dependent and related to the pharmacologic action (ie, increased sodium and water reabsorption) (Ref)

Onset: Varied; may occur at any time during treatment (Ref), especially following treatment initiation or dose titration (Ref).

Risk factors:

• Patients with kidney impairment, including patients undergoing hemodialysis (Ref). Clinicians should note that pericardial effusion may also occur in patients without a history of impaired kidney function (Ref).

• Heart failure

Tachycardia

The use of minoxidil is associated with reflex tachycardia (Ref); the increase in heart rate may increase oxygen demand and precipitate or exacerbate myocardial ischemia and resultant angina. Patients may require intervention (eg, beta-blockade) or treatment discontinuation (Ref).

Mechanism: Dose-related; related to the pharmacologic action (eg, reflex tachycardia secondary to vasodilation (Ref))

Onset: Rapid to intermediate (Ref); one trial investigating the use of oral minoxidil for the treatment of hair loss (n=1404) found a mean onset of tachycardia of 1 day (range: 0 to 7 days) (Ref)

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%:

Cardiovascular: Abnormal T waves on ECG (~60%)

Dermatologic: Hypertrichosis (~80%)

1% to 10%: Cardiovascular: Edema (7% to 10%), pericardial effusion (~3%; including cardiac tamponade)

<1%:

Genitourinary: Breast tenderness

Hypersensitivity: Hypersensitivity reaction

Frequency not defined:

Cardiovascular: Exacerbation of angina pectoris, increased heart rate, increased plasma volume

Hepatic: Increased serum alkaline phosphatase

Renal: Increased blood urea nitrogen, increased serum creatinine

Postmarketing:

Cardiovascular: Pericarditis

Dermatologic: Bullous rash, skin rash, Stevens-Johnson syndrome, toxic epidermal necrolysis

Gastrointestinal: Nausea, vomiting

Hematologic & oncologic: Leukopenia, thrombocytopenia

Hepatic: Ascites (McNay 1983)

Respiratory: Pulmonary edema (Dargie 1977; Lee 2011)

Contraindications

Hypersensitivity to minoxidil or any component of the formulation; pheochromocytoma

Canadian labeling: Additional contraindications (not in US labeling): Pulmonary hypertension associated with mitral stenosis; severe hepatic impairment

Warnings/Precautions

Concerns related to adverse effects:

• Fluid retention: May cause salt and water retention; administer with a diuretic, preferably a loop diuretic (eg, furosemide) to prevent fluid retention and subsequent local and generalized edema. Use with extreme caution in patients with heart failure.

• Pericardial effusion/tamponade: [US Boxed Warning]: May cause pericarditis and pericardial effusion that may progress to tamponade; patients with renal impairment not on dialysis may be at higher risk. Use with caution in patients with heart failure; observe patients closely. If effusion persists, consider discontinuation of minoxidil.

• Rapid blood pressure control: Rapid control of blood pressure in patients with severe hypertension can lead to syncope, cerebrovascular accidents, MI, and/or ischemia of other special sense organs resulting in decrease or loss of vision or hearing. Patients with compromised circulation or cryoglobulinemia may also suffer ischemic episodes of the affected organs.

• Sinus tachycardia: [US Boxed Warning]: May increase oxygen demand and exacerbate angina pectoris; concomitant use with a beta-blocker (if no contraindication exists) may help reduce the effect. Use with caution in patients with ischemic heart disease.

Disease-related concerns:

• Acute myocardial infarct (MI): Avoid use for a month after acute MI as use may increase oxygen demand due to reflex tachycardia. Use with extreme caution; ensure patient is receiving a beta blocker prior to initiation.

• Heart failure: Compared to placebo minoxidil increased the frequency of clinical events, including increased need for diuretics, angina, ventricular arrhythmias, worsening heart failure and death (Franciosa 1984). In a scientific statement from the American Heart Association, minoxidil has been determined to be an agent that may exacerbate underlying myocardial dysfunction (magnitude: moderate) (AHA [Page 2016]).

• Renal impairment: Use with caution in patients with significant renal impairment; renal failure and dialysis patients may require a smaller dose. Monitor closely to prevent exacerbation of renal failure.

Special populations:

• Older adult: Use with caution in the elderly; initiate at the low end of the dosage range and monitor closely.

Other warnings/precautions:

• Appropriate use: [US Boxed Warning]: Maximum therapeutic doses of a diuretic and two other antihypertensives should be used before this drug is ever added. Should be given with a diuretic to minimize fluid gain and a beta-blocker (if no contraindications) to prevent tachycardia and increased myocardial workload. Patients with malignant hypertension and those already receiving guanethidine should be hospitalized with close medical supervision to ensure blood pressure is reducing and to prevent too rapid of a reduction in blood pressure.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Generic: 2.5 mg, 10 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Minoxidil Oral)

2.5 mg (per each): $0.59 - $0.78

10 mg (per each): $1.29 - $1.69

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Loniten: 2.5 mg, 10 mg

Administration: Pediatric

Oral: May be administered without regard to food

Storage/Stability

Store between 20°C and 25°C (68°F and 77°F).

Use

Treatment of hypertension that is symptomatic or associated with target organ damage and is not manageable with maximum therapeutic doses of a diuretic plus 2 other antihypertensives (FDA approved in children, adolescents, and adults). Note: Not recommended for use in milder degrees of hypertension; benefit-risk ratio in such patients has not been defined (AAP [Flynn 2017]; manufacturer's labeling).

Medication Safety Issues
Sound-alike/look-alike issues:

Loniten [CAN] may be confused with Lipitor

Minoxidil may be confused with metOLazone, midodrine, Minipress, Minocin, Monopril, Minoxidin (dietary supplement), Noxafil

International issues:

Noxidil [Thailand] may be confused with Noxafil brand name for posaconazole [US and multiple international markets]

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program

Alfuzosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Amifostine: Blood Pressure Lowering Agents may increase hypotensive effects of Amifostine. Management: When used at chemotherapy doses, hold blood pressure lowering medications for 24 hours before amifostine administration. If blood pressure lowering therapy cannot be held, do not administer amifostine. Use caution with radiotherapy doses of amifostine. Risk D: Consider Therapy Modification

Amphetamines: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Antipsychotic Agents (Second Generation [Atypical]): Blood Pressure Lowering Agents may increase hypotensive effects of Antipsychotic Agents (Second Generation [Atypical]). Risk C: Monitor

Arginine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Barbiturates: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Benperidol: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Brigatinib: May decrease antihypertensive effects of Antihypertensive Agents. Brigatinib may increase bradycardic effects of Antihypertensive Agents. Risk C: Monitor

Brimonidine (Topical): May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Bromperidol: May decrease hypotensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase hypotensive effects of Bromperidol. Risk X: Avoid

CycloSPORINE (Systemic): May increase adverse/toxic effects of Minoxidil (Systemic). Severe hypertrichosis has been reported with this combination. Risk C: Monitor

Dapoxetine: May increase orthostatic hypotensive effects of Minoxidil (Systemic). Risk C: Monitor

Dexmethylphenidate: May decrease therapeutic effects of Antihypertensive Agents. Risk C: Monitor

Diazoxide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

DULoxetine: Blood Pressure Lowering Agents may increase hypotensive effects of DULoxetine. Risk C: Monitor

Flunarizine: May increase therapeutic effects of Antihypertensive Agents. Risk C: Monitor

Guanethidine: May increase hypotensive effects of Minoxidil (Systemic). Management: When possible, discontinue guanethidine prior to initiation of minoxidil due to a risk of severe orthostasis and hypotension. If combined, minoxidil therapy should be initiated in the hospital, with close monitoring of blood pressure. Risk D: Consider Therapy Modification

Herbal Products with Blood Pressure Increasing Effects: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Herbal Products with Blood Pressure Lowering Effects: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Hypotension-Associated Agents: Blood Pressure Lowering Agents may increase hypotensive effects of Hypotension-Associated Agents. Risk C: Monitor

Iloperidone: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Indoramin: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Isocarboxazid: May increase antihypertensive effects of Antihypertensive Agents. Risk X: Avoid

Levodopa-Foslevodopa: Blood Pressure Lowering Agents may increase hypotensive effects of Levodopa-Foslevodopa. Risk C: Monitor

Loop Diuretics: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Lormetazepam: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Metergoline: May decrease antihypertensive effects of Blood Pressure Lowering Agents. Blood Pressure Lowering Agents may increase orthostatic hypotensive effects of Metergoline. Risk C: Monitor

Methylphenidate: May decrease antihypertensive effects of Antihypertensive Agents. Risk C: Monitor

Molsidomine: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Naftopidil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicergoline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nicorandil: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Nitroprusside: Blood Pressure Lowering Agents may increase hypotensive effects of Nitroprusside. Risk C: Monitor

Obinutuzumab: May increase hypotensive effects of Blood Pressure Lowering Agents. Management: Consider temporarily withholding blood pressure lowering medications beginning 12 hours prior to obinutuzumab infusion and continuing until 1 hour after the end of the infusion. Risk D: Consider Therapy Modification

Pentoxifylline: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Perazine: May increase hypotensive effects of Antihypertensive Agents. Risk C: Monitor

Pholcodine: Blood Pressure Lowering Agents may increase hypotensive effects of Pholcodine. Risk C: Monitor

Phosphodiesterase 5 Inhibitors: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Prazosin: Antihypertensive Agents may increase hypotensive effects of Prazosin. Risk C: Monitor

Prostacyclin Analogues: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Quinagolide: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Silodosin: May increase hypotensive effects of Blood Pressure Lowering Agents. Risk C: Monitor

Terazosin: Antihypertensive Agents may increase hypotensive effects of Terazosin. Risk C: Monitor

Urapidil: Antihypertensive Agents may increase hypotensive effects of Urapidil. Risk C: Monitor

Pregnancy Considerations

Adverse events were observed in some animal studies. Neonatal hypertrichosis has been reported following exposure to minoxidil during pregnancy.

Monitoring Parameters

Blood pressure, standing and sitting/supine; signs/symptoms of pericardial effusion; fluid and electrolyte balance, heart rate, urine output, and body weight should be monitored. Any tests that are abnormal at the time of initiation (including urinalysis, renal function tests, CBC, ECG, echocardiogram, chest x-ray) should be repeated every 1 to 3 months until stabilized, then every 6 to 12 months.

Mechanism of Action

Produces vasodilation by directly relaxing arteriolar smooth muscle, with little effect on veins; effects may be mediated by cyclic AMP; stimulation of hair growth is secondary to vasodilation, increased cutaneous blood flow and stimulation of resting hair follicles

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Hypotensive: ~30 minutes

Peak effect: 2 to 3 hours

Duration: Up to 2 to 5 days

Protein binding: None

Metabolism: ~90%, primarily via glucuronidation

Bioavailability: 90%

Half-life elimination: 3.5 to 4.2 hours

Excretion: Urine (12% as unchanged)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AR) Argentina: Combinater | Ivix hta | Lonolox | Minocass;
  • (AT) Austria: Loniten;
  • (AU) Australia: Loniten;
  • (BE) Belgium: Lonnoten;
  • (BR) Brazil: Loniten;
  • (CH) Switzerland: Loniten;
  • (CO) Colombia: Minox | Minoxiten | Vaxdil;
  • (CZ) Czech Republic: Loniten;
  • (DE) Germany: Loniten | Lonolox | Lonoten;
  • (DO) Dominican Republic: Minoxiten;
  • (EC) Ecuador: Minoxiten;
  • (EE) Estonia: Lonitab | Lonolox;
  • (ES) Spain: Loniten;
  • (FI) Finland: Lonnoten | Minona;
  • (FR) France: Lonoten;
  • (GB) United Kingdom: Loniten;
  • (GR) Greece: Loniten | Lonnoten | Lonoten | Oxofenil;
  • (HK) Hong Kong: Loniten;
  • (HU) Hungary: Loniten;
  • (IE) Ireland: Loniten;
  • (IN) India: Dilminox | Dutamax m | Lonit | Nexidil | Staha | Xtra denser m;
  • (IT) Italy: Loniten;
  • (KR) Korea, Republic of: Bimo | Dhnp minoxidil | Dongkwang Minoxidil | Highnoxil | Hyundai minoxidil | Introminoxidil | Loniten | Momosidil | Plexidil | Uni minoxidil;
  • (LT) Lithuania: Lonitab | Loniten | Lonolox | Minoxiheart;
  • (LU) Luxembourg: Lonnoten;
  • (LV) Latvia: Loniten;
  • (MX) Mexico: Cutem minoxidil;
  • (MY) Malaysia: Hirsutin | Loniten;
  • (NL) Netherlands: Lonnoten;
  • (NO) Norway: Loniten | Lonnoten | Lonolox | Minoxidil sun pharm;
  • (NZ) New Zealand: Loniten;
  • (PL) Poland: Loniten | Lonolox | Lonoten;
  • (PR) Puerto Rico: Loniten;
  • (PT) Portugal: Loniten;
  • (RO) Romania: Loniten;
  • (SG) Singapore: Loniten;
  • (SI) Slovenia: Loniten;
  • (SK) Slovakia: Loniten;
  • (TH) Thailand: Loniten | Loxidil | Manoxidil | Minoxy | Modil | Mpb | Noxidil | Pipminox | Sm 2 | Sm-1;
  • (TW) Taiwan: Hirsutin | Loniten | Midil | Minoten;
  • (VE) Venezuela, Bolivarian Republic of: Guayaten;
  • (ZA) South Africa: Loniten
  1. Adams MH, Poynor WJ, Garnett WR, et al. Pharmacokinetics of minoxidil in patients with cirrhosis and healthy volunteers. Biopharm Drug Dispos. 1998;19(8):501-515. [PubMed 9840212]
  2. Akinleye A, Jamil Y, Dogbey P. Minoxidil-induced pleuro-pericardial effusion with tamponade. Cureus. 2023;15(10):e46416. doi:10.7759/cureus.46416 [PubMed 37927730]
  3. Asilian A, Farmani A, Saber M. Clinical efficacy and safety of low-dose oral minoxidil versus topical solution in the improvement of androgenetic alopecia: A randomized controlled trial. J Cosmet Dermatol. 2024;23(3):949-957. doi:10.1111/jocd.16086 [PubMed 38031516]
  4. Baker BA, Ruck B, Pellman E. Minoxidil-associated pericardial effusion. Drug Intell Clin Pharm. 1987;21(9):753. doi:10.1177/106002808702100920 [PubMed 3652940]
  5. Bennett WM. Pericardial effusions associated with minoxidil. Lancet. 1977;2(8052-8053):1356. doi:10.1016/s0140-6736(77)90402-0 [PubMed 74759]
  6. Brook RD, Townsend RR. Treatment of resistant hypertension. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. https://www.uptodate.com. Accessed June 2, 2022.
  7. Bryan RK, Hoobler SW, Rosenzweig J, Weller JM, Purdy JM. Effect of minoxidil on blood pressure and hemodynamics in severe hypertension. Am J Cardiol. 1977;39(6):796-801. doi:10.1016/s0002-9149(77)80029-5 [PubMed 324257]
  8. Burton JL, Marshall A. Hypertrichosis due to minoxidil. Br J Dermatol. 1979;101(5):593-595. [PubMed 518830]
  9. Campese VM, Stein D, DeQuattro V. Treatment of severe hypertension with minoxidil: advantages and limitations. J Clin Pharmacol. 1979;19(4):231-241. doi:10.1002/j.1552-4604.1979.tb01657.x [PubMed 374429]
  10. Çilingiroğlu M, Akkuş N, Sethi S, Modi KA. Large pericardial effusion induced by minoxidil. Turk Kardiyol Dern Ars. 2012;40(3):255-258. doi:10.5543/tkda.2012.63904 [PubMed 22864322]
  11. Dargie HJ, Dollery CT, Daniel J. Minoxidil in resistant hypertension. Lancet. 1977;2(8037):515-518. doi:10.1016/s0140-6736(77)90660-2 [PubMed 95728]
  12. Deutsch SB, Berlowitz M. Minoxidil associated pericardial effusion: A case report. Journal of Medical Cases. 2015;6(2):65-67.
  13. Dlova NC, Jacobs T, Singh S. Pericardial, pleural effusion and anasarca: A rare complication of low-dose oral minoxidil for hair loss. JAAD Case Rep. 2022;28:94-96. doi:10.1016/j.jdcr.2022.07.044 [PubMed 36117778]
  14. do Nascimento IJB, Harries M, Rocha VB, et al. Effect of oral minoxidil for alopecia: Systematic review. Int J Trichology. 2020;12(4):147-155. doi:10.4103/ijt.ijt_19_20 [PubMed 33376283]
  15. Dunea G, Mamdani B, Mahurkar SD. Treatment of severe and moderate hypertension with minoxidil: experience in twenty-eight patients. Clin Sci Mol Med Suppl. 1976;3:583s-585s. doi:10.1042/cs051583s [PubMed 799567]
  16. Flynn JT, Kaelber DC, Baker-Smith CM, et al; Subcommittee on Screening and Management of High Blood Pressure in Children. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics. 2017;140(3):e20171904. doi:10.1542/peds.2017-3035 [PubMed 29192011]
  17. Flynn JT, Tullus K. Severe hypertension in children and adolescents: pathophysiology and treatment. Pediatr Nephrol. 2009;24(6):1101-1112. doi:10.1007/s00467-008-1000-1 [PubMed 18839219]
  18. Franciosa JA, Jordan RA, Wilen MM, et al, “Minoxidil in Patients With Chronic Left Heart Failure: Contrasting Hemodynamic and Clinical Effects in a Controlled Trial,” Circulation, 1984, 70(1):63-8. [PubMed 6373050]
  19. Gbadamosi WA, Melvin J, Lopez M. Atypical case of minoxidil-induced generalized anasarca and pleuropericardial effusion. Cureus. 2021;13(6):e15424. doi:10.7759/cureus.15424 [PubMed 34249570]
  20. Go AS, Bauman M, King SM, et al. An effective approach to high blood pressure control: a science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention [published online November 15, 2013]. Hypertension. [PubMed 24243703]
  21. Gupta AK, Hall DC, Talukder M, Bamimore MA. There is a positive dose-dependent association between low-dose oral minoxidil and its efficacy for androgenetic alopecia: Findings from a systematic review with meta-regression analyses. Skin Appendage Disord. 2022;8(5):355-361. doi:10.1159/000525137 [PubMed 36161084]
  22. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. [PubMed 24352797]
  23. Jimenez-Cauhe J, Saceda-Corralo D, Rodrigues-Barata R, et al. Safety of low-dose oral minoxidil treatment for hair loss. A systematic review and pooled-analysis of individual patient data. Dermatol Ther. 2020;33(6):e14106. doi:10.1111/dth.14106 [PubMed 32757405]
  24. Lee C, Chen K, Kao H. Minoxidil-related renal function deterioration and pulmonary edema: A case report and literature review. Acta Nephrologica. 2011; 25(1):33-36. Available at http://www.tsn.org.tw/tsnFile/journal/catalog/D8CDBE5E9A81035C/33-36.pdf.
  25. Lew MJ, Amato J. Minoxidil-associated pericardial effusion and impending tamponade. JAAPA. 2023;36(12):21-23. doi:10.1097/01.JAA.0000944608.70893.b3 [PubMed 37989166]
  26. Loniten (minoxidil) [prescribing information]. New York, NY: Pfizer, Inc; January 2015.
  27. Loniten (minoxidil) [product monograph]. Kirkland, Quebec, Canada: Pfizer Canada Inc; November 2013.
  28. Martin WB, Spodick DH, Zins GR. Pericardial disorders occurring during open-label study of 1,869 severely hypertensive patients treated with minoxidil. J Cardiovasc Pharmacol. 1980;2 Suppl 2:S217-27. doi:10.1097/00005344-198000022-00016 [PubMed 6156358]
  29. McNay JL, Dole WP. Efficacy of captopril in relieving congestive heart failure developing during management of hypertension. Case report. Hypertension. 1983;5(3):390-393. doi:10.1161/01.hyp.5.3.390 [PubMed 6341222]
  30. Minoxidil [prescribing information]. Parsippany, NJ: Teva Pharmaceuticals; February 2024.
  31. Minoxidil [prescribing information]. Pulaski, TN: AvKARE Inc; July 2013.
  32. National Institutes of Health, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents. Clinical Practice Guidelines, 2011. Available at http://www.nhlbi.nih.gov/guidelines/cvd_ped/peds_guidelines_full.pdf. Date accessed: June 11, 2012.
  33. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. http://www.nhlbi.nih.gov/files/docs/resources/heart/hbp_ped.pdf. Updated May 2005. Accessed February 2, 2015. [PubMed 15286277]
  34. Page RL 2nd, O'Bryant CL, Cheng D, et al; American Heart Association Clinical Pharmacology and Heart Failure and Transplantation Committees of the Council on Clinical Cardiology; Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular and Stroke Nursing; and Council on Quality of Care and Outcomes Research. Drugs That May Cause or Exacerbate Heart Failure: A Scientific Statement From the American Heart Association [published correction appears in Circulation. 2016;134(12):e261]. Circulation. 2016;134(6):e32-e69. [PubMed 27400984]
  35. Park MK, Salamat M. Park's Pediatric Cardiology for Practitioners. 7th ed. Elsevier Health Sciences; 2021:chap. 28, appendix E.
  36. Penha MA, Miot HA, Kasprzak M, Müller Ramos P. Oral minoxidil vs topical minoxidil for male androgenetic alopecia: A randomized clinical trial. JAMA Dermatol. 2024;160(6):600-605. doi:10.1001/jamadermatol.2024.0284 [PubMed 38598226]
  37. Pennisi AJ, Takahashi M, Bernstein BH, et al. Minoxidil therapy in children with severe hypertension. J Pediatr. 1977;90(5):813-819. doi:10.1016/s0022-3476(77)81260-2 [PubMed 323442]
  38. Refer to manufacturer's labeling.
  39. Reichgott MJ. Minoxidil and pericardial effusion: an idiosyncratic reaction. Clin Pharmacol Ther. 1981;30(1):64-70. doi:10.1038/clpt.1981.128 [PubMed 7237900]
  40. Sannerstedt R, Brorson L, Berglund G, Werkö L. Minoxidil--haemodynamic and clinical experiences with a new peripheral vasodilator. Acta Med Scand. 1975;197(5):409-414. doi:10.1111/j.0954-6820.1975.tb04941.x [PubMed 238365]
  41. Sharma AN, Michelle L, Juhasz M, Muller Ramos P, Atanaskova Mesinkovska N. Low-dose oral minoxidil as treatment for non-scarring alopecia: a systematic review. Int J Dermatol. 2020;59(8):1013-1019. doi:10.1111/ijd.14933 [PubMed 32516434]
  42. Shirwany A, D'Cruz IA, Munir A. Very large pericardial effusion attributable to minoxidil: resolution without drainage of fluid. Echocardiography. 2002;19(6):513-516. doi:10.1046/j.1540-8175.2002.00513.x [PubMed 12356348]
  43. Vañó-Galván S, Pirmez R, Hermosa-Gelbard A, et al. Safety of low-dose oral minoxidil for hair loss: A multicenter study of 1404 patients. J Am Acad Dermatol. 2021;84(6):1644-1651. doi:10.1016/j.jaad.2021.02.054 [PubMed 33639244]
  44. Weber MA, Schiffrin EL, White WB, et al. Clinical Practice Guidelines for the Management of Hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hyperten (Greenwich). 2014;16(1):14-26. [PubMed 24341872]
  45. Wells JO. Unusual cases of resistance to minoxidil therapy. J Cardiovasc Pharmacol. 1980;2 Suppl 2:S228-35. doi:10.1097/00005344-198000022-00017 [PubMed 6156359]
  46. Werning C. The effect of minoxidil on blood pressure and plasma renin activity in patients with essential and renal hypertension. Klin Wochenschr. 1976;54(15):727-734. doi:10.1007/BF01470464 [PubMed 790007]
  47. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018;71(6):e13‐e115. doi:10.1161/HYP.0000000000000065 [PubMed 29133356]
  48. Yasin M, Gyawali S, Khan A. Idiosyncratic pericardial effusion associated with minoxidil. Am J Ther. 2018;25(6):e745-e747. doi:10.1097/MJT.0000000000000757 [PubMed 29746289]
  49. Zacest R, Frewin DB, Robinson MA, et al. Clinical and haemodynamic effects of minoxidil in refractory hypertension. Drugs. 1976;11 SUPPL 1:177-84. doi:10.2165/00003495-197600111-00036 [PubMed 776581]
  50. Zarate A, Gelfand MC, Horton JD, et al. Pericardial effusion associated with minoxidil therapy in dialyzed patients. Int J Artif Organs. 1980;3(1):15-17. [PubMed 7353909]
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