From the Guidelines
Minoxidil, whether oral or topical, may potentially exacerbate gout in some individuals due to its side effect of fluid retention, which can decrease uric acid excretion and raise serum uric acid levels, triggering gout flares. This occurs particularly at higher doses and more commonly with oral formulations than topical ones. Oral minoxidil poses a greater risk than topical formulations since systemic absorption is much higher with oral administration. Patients with a history of gout who are using or considering minoxidil should monitor for signs of gout flares, including joint pain, swelling, and redness, particularly in the big toe, ankles, or knees.
- Key considerations for patients with gout using minoxidil include:
- Monitoring for gout flares
- Preferably using topical minoxidil to minimize systemic effects
- Discussing potential adjustments to gout medications or minoxidil dosage with a healthcare provider if gout symptoms worsen
- Staying well-hydrated to promote uric acid excretion According to the most recent and highest quality study available, 1, the management of acute and recurrent gout involves considering the potential effects of various medications, including minoxidil, on uric acid levels and gout symptoms. While the study does not specifically address minoxidil, its discussion on the importance of monitoring and managing gout symptoms and uric acid levels is relevant to the consideration of minoxidil's potential impact on gout.
From the Research
Minoxidil and Gout
- There is no direct evidence to suggest that minoxidil (oral or topical) exacerbates gout 2, 3, 4, 5.
- However, minoxidil is used to treat hypertension, and diuretics, which are often used to treat hypertension, can increase the risk of gout 2, 4, 5.
- Minoxidil can cause hyperfiltration, which may lead to increased proteinuria and loss of renoprotection conferred by angiotensin inhibition 6.
- Gout is caused by monosodium urate crystal deposition in joints and tissues, and risk factors include hypertension, among others 5.
- Treatment of gout typically involves nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids, as well as lifestyle modifications and urate-lowering therapy 2, 4, 5.
Potential Interactions
- There is no direct evidence of interactions between minoxidil and gout medications, but patients with gout should be monitored for potential changes in renal function and proteinuria when taking minoxidil 6.
- Patients with hypertension and gout should be managed carefully, as diuretics and other antihypertensive medications can affect uric acid levels and gout symptoms 2, 4, 5.