From the Guidelines
Minoxidil is contraindicated in patients with pulmonary hypertension and should be used with caution in patients with severe aortic stenosis, renal impairment, or heart failure.
Contraindications and Precautions
- Hirsutism: Minoxidil can cause excessive hair growth, which may be a concern for some patients 1.
- Pericardial effusion: Minoxidil can induce pericardial effusion, which is a serious side effect that requires close monitoring 1.
- Reflex tachycardia: Minoxidil can cause reflex tachycardia, which may be a concern for patients with pre-existing heart conditions 1.
- Fluid retention: Minoxidil can cause fluid retention, which may be a concern for patients with renal impairment or heart failure 1.
Special Considerations
- Pregnancy and lactation: Minoxidil should be used with caution in pregnant or breastfeeding women, as its safety in these populations has not been established 1.
- Pediatric use: Minoxidil has not been studied in pediatric patients, and its safety and efficacy in this population are unknown 1. It is essential to carefully evaluate the potential benefits and risks of minoxidil therapy in each patient and to monitor them closely for adverse effects. Minoxidil should only be considered if all other pharmacological agents prove ineffective in resistant hypertension, as stated in the 2024 ESC guidelines 1.
From the FDA Drug Label
• Women should not use minoxidil topical solution 5% because studies have shown it works no better in women than minoxidil topical solution 2%. Some women may also grow facial hair In addition, minoxidil topical solution 5% may be harmful if used during pregnancy or breast-feeding. • Minoxidil topical solution 5% should not be used on babies or for children under 18 years old Do not use if • you are a woman • your amount of hair loss is different than that shown on the other side of this leaflet or your hair loss is on the front of the scalp. • you have no family history of hair loss • your hair loss is sudden and/or patchy • you do not know the reason for your hair loss • you are under 18 years of age. • scalp is red, inflamed, infected, irritated, or painful • you use other medicines on the scalp
The contraindications for Minoxidil (minoxidil) are:
- Women, especially those who are pregnant or breastfeeding
- Children under 18 years old
- Individuals with certain scalp conditions, such as redness, inflammation, infection, irritation, or pain
- Individuals using other medicines on the scalp
- Individuals with hair loss that is sudden, patchy, or has no known cause
- Individuals with hair loss on the front of the scalp (frontal baldness or receding hairline) 2 2
From the Research
Contraindications for Minoxidil
- The provided studies do not explicitly list contraindications for minoxidil 3, 4, 5, 6, 7.
- However, it can be inferred that minoxidil may be contraindicated in certain patients due to its potential side effects, such as:
- Reflex tachycardia, renin stimulation, and sodium retention, which may require concomitant use of a diuretic and a sympathoplegic agent 3.
- Hirsutism and pericardial effusions, which are additional adverse effects of minoxidil 3.
- Allergic reactions to the nonactive ingredient propylene glycol, which is found in some topical solutions 4.
- Irritant and allergic contact dermatitis on the scalp, which are common adverse reactions of the topical formulation 4.
- Topical minoxidil is not FDA-approved in patients under 18 years old, and there are no guidelines for its pediatric use 6.
- Low-dose oral minoxidil may be considered in certain situations, but there are no guidelines regarding the ideal dose or minimum age for using the drug topically or systemically 6.