What is the recommended dosage range for oral minoxidil (minoxidil) for the treatment of hair loss?

Oral Minoxidil Dosage Range for Hair Loss

The recommended dosage range for oral minoxidil in treating hair loss is 0.25-2.5 mg daily for women and 2.5-5 mg daily for men with androgenetic alopecia. 1, 2

Dosage Recommendations by Gender

• Women typically require lower doses ranging from 0.25 to 2.5 mg daily for effective treatment of female pattern hair loss 2
• Men generally need higher doses ranging from 2.5 to 5 mg daily for male pattern hair loss 2
• Low-dose oral minoxidil (LDOM) defined as ≤5 mg/day has shown efficacy with fewer side effects than higher doses 3, 1

Efficacy Data

• Studies show that oral minoxidil at these doses can lead to objective clinical improvement in 61-100% of patients with androgenetic alopecia 4
• A randomized controlled trial comparing 1 mg daily oral minoxidil with 5% topical minoxidil found no significant difference in efficacy between the two formulations 5
• Both treatments showed significant improvement in hair diameter after 6 months (p < 0.001) 5
• Patient satisfaction rates exceeded 60% for both oral and topical formulations 5

Higher Dose Considerations

• Higher doses (>5 mg daily) have been studied with variable responses 6
• In a retrospective study of 57 patients using higher doses:
  • 17.5% of patients experienced significant improvements (>50% increase in hair density)
  • Most patients showed 10-30% improvement in hair density
  • 17.5% showed minimal improvement (<10%) 6
• Higher doses carry increased risk of adverse effects and should be reserved for cases resistant to standard dosing 6

Safety Profile and Adverse Effects

• The most common adverse effects of oral minoxidil include:
  • Hypertrichosis (unwanted hair growth in non-scalp areas) - reported in 17.5% of patients on higher doses 6
  • Postural hypotension 4
  • Tachycardia (3.5% in higher dose studies) 6
• The low side-effect profile of low-dose oral minoxidil allows for long-term adherence 1
• Adverse effects are dose-dependent, with higher rates at doses exceeding 5 mg daily 6

Practical Advantages Over Topical Formulation

• Enhanced cosmesis (no greasy residue on hair) 1
• Cost savings compared to long-term topical application 1
• Possibility of co-therapy with other topical formulations 1
• Improved patient compliance compared to twice-daily topical application 4

Starting and Adjusting Therapy

• Begin with the lower end of the dosage range (0.25-1 mg for women, 2.5 mg for men) 1, 2
• Monitor for efficacy and side effects over 3-6 months 5
• Dose can be adjusted upward within the recommended range if response is inadequate and side effects are minimal 2
• Treatment typically requires 6 months or longer to observe maximum benefit 5

Special Considerations

• Patients unable to tolerate topical minoxidil are good candidates for oral therapy 1
• Oral minoxidil may be particularly useful for patients with poor adherence to topical regimens 2
• Caution is advised in patients with cardiovascular conditions due to potential for hypotension and tachycardia 6