From the Guidelines
Minoxidil is indicated for the treatment of resistant hypertension.
Key Points
- Minoxidil is a potent vasodilator that can be effective in lowering blood pressure in patients with resistant hypertension 1.
- It is typically considered a fourth-line or later addition to the treatment regimen due to its potential for adverse effects, such as fluid retention and tachycardia 1.
- The use of minoxidil is often reserved for patients who have not responded to other treatments, including combination therapy with other antihypertensive agents 1.
- When used, minoxidil is often combined with other medications, such as beta-blockers and diuretics, to mitigate its adverse effects 1.
Evidence Summary
The 2024 ESC guidelines for the management of elevated blood pressure and hypertension recommend minoxidil as a last-line treatment option for resistant hypertension 1. The 2018 ACC/AHA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults also supports the use of minoxidil in patients with resistant hypertension 1. The ASH/ISH guidelines suggest that minoxidil should only be considered as a fourth-line or later addition to the treatment regimen due to its potential for adverse effects 1. Overall, the evidence suggests that minoxidil is a potent antihypertensive agent that can be effective in lowering blood pressure in patients with resistant hypertension, but its use should be carefully considered due to its potential for adverse effects.
From the Research
Indications for Oral Minoxidil
The indications for oral minoxidil are varied and include:
- Androgenetic alopecia, with studies showing significant improvement in hair growth and density 2, 3, 4, 5
- Alopecia areata, with some studies demonstrating rapid and extensive hair regrowth, although cosmetic response may be limited 2, 6
- Female pattern hair loss, with oral minoxidil providing a promising treatment option 2, 5
- Chronic telogen effluvium, with successful treatment reported in some studies 2
- Monilethrix and permanent chemotherapy-induced alopecia, with oral minoxidil showing therapeutic benefits 2
- Other forms of non-scarring and scarring alopecia, with oral minoxidil used at lower dosages and showing promising results 5
Key Findings
- Oral minoxidil has been shown to be a safe and effective treatment for androgenetic alopecia and alopecia areata, with significant improvements in hair growth and density 2, 3
- The most common adverse effects of oral minoxidil include hypertrichosis and postural hypotension 2, 3, 4
- Oral minoxidil has been compared to topical minoxidil in some studies, with similar efficacy and safety profiles reported 4