What is the interaction between Minoxidil (Rogaine) and Naltrexone (Naltrexone)?

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Last updated: May 9, 2025View editorial policy

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From the Guidelines

Minoxidil with naltrexone should not be used as a first-line treatment for hair loss due to the potential side effects and lack of strong evidence supporting its efficacy, and instead, minoxidil alone should be considered as the initial treatment option 1. When considering the use of minoxidil with naltrexone, it is essential to weigh the potential benefits against the risks. Minoxidil is a well-established treatment for hair loss, and its mechanism of action involves increasing blood flow to hair follicles and prolonging the growth phase 1. On the other hand, naltrexone is an opioid antagonist that has been used off-label for various conditions, including hair loss, but its efficacy and safety for this indication are not well established 1. Some studies suggest that low-dose naltrexone (LDN) may have anti-inflammatory properties and potentially enhance hair follicle function, but more research is needed to confirm these findings 1. The standard approach for using minoxidil with naltrexone involves applying a topical solution containing 2% or 5% minoxidil and 0.01% to 0.1% naltrexone to the scalp once or twice daily. However, it is crucial to consider the potential side effects of this combination, including scalp irritation, unwanted hair growth in adjacent areas, and initial increased shedding in the first few weeks 1. Additionally, naltrexone has been associated with hepatic injury at supratherapeutic doses, and liver function tests should be monitored regularly 1. In conclusion, while minoxidil with naltrexone may be considered as a treatment option for hair loss, it is essential to consult with a dermatologist before starting this regimen and to carefully weigh the potential benefits against the risks.

Key Points

  • Minoxidil is a well-established treatment for hair loss, and its mechanism of action involves increasing blood flow to hair follicles and prolonging the growth phase 1.
  • Naltrexone is an opioid antagonist that has been used off-label for various conditions, including hair loss, but its efficacy and safety for this indication are not well established 1.
  • The potential side effects of minoxidil with naltrexone include scalp irritation, unwanted hair growth in adjacent areas, and initial increased shedding in the first few weeks 1.
  • Naltrexone has been associated with hepatic injury at supratherapeutic doses, and liver function tests should be monitored regularly 1.

From the Research

Minoxidil and Naltrexone Combination

  • There is no direct evidence in the provided studies to support the use of minoxidil with naltrexone for hair loss treatment 2, 3, 4.
  • Minoxidil is FDA-approved for androgenetic alopecia (AGA) in men and women, and its mechanism of action involves multiple pathways, including vasodilation, anti-inflammatory effects, and induction of the Wnt/β-catenin signaling pathway 2.
  • Naltrexone is used for alcohol and opioid dependence treatment, and its extended-release form has been shown to improve adherence and reduce healthcare utilization costs 5.
  • Low-dose naltrexone has been investigated for its potential in treating chronic pain conditions, with proposed mechanisms involving modulation of neuro-inflammation 6.
  • While oral minoxidil has been suggested as a potential treatment for hair loss, its effectiveness and safety require further investigation with high-quality randomized controlled trials 3, 4.

Potential Interactions and Considerations

  • There is no evidence to suggest a direct interaction between minoxidil and naltrexone, but their combined use may require careful consideration of potential side effects and efficacy 2, 5.
  • The use of minoxidil, particularly oral forms, may be associated with adverse events, and its combination with naltrexone may require monitoring for increased risk of side effects 3, 4.
  • Further research is needed to determine the safety and efficacy of combining minoxidil with naltrexone for hair loss treatment or other indications 2, 3, 5, 4, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Minoxidil: a comprehensive review.

The Journal of dermatological treatment, 2022

Research

Oral minoxidil treatment for hair loss: A review of efficacy and safety.

Journal of the American Academy of Dermatology, 2021

Research

Effect of Oral Minoxidil for Alopecia: Systematic Review.

International journal of trichology, 2020

Research

Low-Dose Naltrexone for Chronic Pain: Update and Systemic Review.

Current pain and headache reports, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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