From the Research
Oral minoxidil can be used with caution in patients with glaucoma, but careful monitoring is advised due to potential effects on ocular perfusion pressure and intraocular pressure. The primary concern with using oral minoxidil in patients with glaucoma is the potential for significant drops in blood pressure, which could theoretically affect ocular perfusion pressure in some patients with glaucoma 1. Additionally, fluid retention, a common side effect of oral minoxidil, might require diuretics, which themselves can affect intraocular pressure in some cases.
Key Considerations
- Patients with glaucoma should inform their ophthalmologist about taking minoxidil, as regular eye pressure monitoring may be advisable.
- The standard dosing for hypertension typically starts at 5 mg once daily, which can be gradually increased to 10-40 mg daily in divided doses if needed.
- Patients should report any changes in vision or eye discomfort while taking this medication, and regular follow-ups with both their prescribing physician and ophthalmologist are recommended to ensure optimal management of both conditions.
- A case report suggests that minoxidil can induce ophthalmic hypertension, highlighting the need for careful monitoring 1.
Evidence Review
While there is no direct contraindication between oral minoxidil and glaucoma, the potential effects on ocular perfusion pressure and intraocular pressure necessitate caution. Studies on the treatment of glaucoma have focused on various medications, including prostaglandins and beta blockers, which have shown efficacy in reducing intraocular pressure 2. However, the use of oral minoxidil in patients with glaucoma requires careful consideration of the potential risks and benefits.
Recommendations
Patients with glaucoma who are prescribed oral minoxidil should be closely monitored for changes in intraocular pressure and ocular perfusion pressure. Regular follow-ups with both their prescribing physician and ophthalmologist are essential to ensure optimal management of both conditions. If significant changes in vision or eye discomfort occur, the patient should report these promptly, and adjustments to their treatment regimen may be necessary 1.