Anybody here use oral minoxidil?

[munchkinman]

Hi, I am considering taking oral minoxidil, after reading a post from a doc on here saying that it caused hair growth so individuals that were not candidates for a HT became eligible for one. I am on finasteride, but it seems to be having no effect as my hair loss is progressing, so I am trying to find other ways around the problem, and I am reluctant to take dutasteride due to unknown long term side effects. Topical minoxidil is not an option for me as I use dermmatch, and live in a student house so I can not walk around without concealer on whilst the minoxdil dries, also I used it for a while and it gave me flaky skin.

So does anyone on here have any actual experience of using oral minoxidil, or know of anyone that does?

Thanks.

[Blake Bloxham]

Munchkin,

 

The usage of oral minoxidil has been a point of pseudo-controversy on the site for sometime (in my opinion). As of now, oral minoxidil (in the 2.5%, 5%, or 10+%) is not cleared by the U.S. Food and Drug Administration as a safe and effective treatment for hair loss.

 

However, there have been several cases on the discussion forums where members have utilized oral minoxidil for hair loss successfully, and one Coalition physician, Dr. Pathomvanich, who regularly prescribes the 5% (if I recall correctly) oral dosage in his clinic.

 

At this point in time, I would personally recommend utilizing topical minoxidil treatments. I know you've mentioned that this could conflict with your camouflaging topical, but I still think it's something worth researching. Frankly, I would love to see (and possibly help organize, proctor, and author ) an organized clinical trial further investigating oral minoxidil for hair loss.

 

Having said that, below is a post where Dr. Pathomvanich explains his views and opinions on prescribing and using oral minoxidil:

 

Thanks for allowing me to share my experience for the use of Oral Minoxidil in the treatment of Androgenic Alopecia.

 

Minoxidil is a peripheral vasodilator used officially as an antihypertensive. It occurs as a white crystalline powder and is soluble in alcohol, propylene glycol and slightly soluble in water.

 

The chemical name is 2, 4, - pyrimidine-diamine, 6-(1- piperidinyl), 3-oxide with molecular wt. 209.25.

 

More than 90% of drug is absorbed from gastrointestinal tract, reaching the maximum plasma level within first hour and declining rapidly thereafter. The average half-life in humans is 4.2 hours. Approximately 90% is metabolized predominantly in Liver by conjugation with glucuronic acid, with some by conversion to more polar products. All metabolites are excreted in urine.

 

Minoxidil is a direct acting peripheral vasodilator capable of reducing both elevated systolic and diastolic blood pressure. It does not interfere with the vasomotor reflux and is therefore unlikely to produce orthostatic hypotension. The primary use is for the treatment of hypertension.

 

Dosage is usually 2.5 to 100 mg per day as a single dose for adults.

 

The side effect is salt and water retention, with swelling of hands and feet, face, lower legs; rapid weight gain can occur.

 

Cardiovascular effects including chest pain, hypotension, and fast and irregular heart beat are possible effects. Hypertrichiosis without virilism as elongation, thickening and increased pigmentation of fine body hair are seen in about 80% of users, developing within 3-6 weeks after starting the therapy. Hypertrichosis is usually first noticed on the temples, glabella, forehead or along the sideburns. Later it may extend to a back, arms, legs, and scalp. Upon discontinuation of minoxidil the growth of new hair is arrested, but 1- 6 months may be required to resume pretreatment appearance. No endocrine abnormalities have been found to explain to this abnormal hair growth.

 

Other effects like thrombocytopenia, nausea, vomiting are uncommon. Breast tenderness occurs in less than 1%. Allergic rashes, blurred vision; flushing of the skin; headache; decreased sexual desire or impotence; numbness or tingling in the hands, feet or face have all been reported.

 

Contraindication

Minoxidil should not be used in Pheochromocytoma or those who are sensitive to the components of the preparations. It may produce pericardial effusion and occasional tamponade. Angina pectoris may be exacerbated. Full details of the drug usage and side effects may be found in the PDR.

 

Minoxidil may pass from mother to the child through breast milk. Therefore, women who are pregnant and breast feeding should not useminoxidil.

 

When I started my private practice 20 years ago, I have seen a large number of patients who were taking oral minoxidil other thanminoxidil lotion from other physicians and some patients even took on their own. I was entirely against taking oral minoxidil since it is not approved by the FDA and encouraged those patients to change to minoxidil lotion only, in fear of the side effects from oral minoxidil. After many years of practice, I have realized the remarkable effect on hair growth from oral minoxidil compared with the lotion. In many patients the result has changed from minimal hair over the scalp i.e. miniaturized hair to the cosmetic fullness of hair i.e. more terminal hair growth over both the front and the crown areas. Some have responded only at the crown but not at the front; also, there were patients who did not respond other than hypertrichosis. I have a few patients, whom I turned them down for hair transplantation surgery since they were poor candidates’ i.e. poor donor and severe degree of hair loss. One of them took oral minoxidil on his own and I was amazed when he returned to see me in four months, his temples hair was full with moderate hair growth at the crown but not at the front and made him a candidate for hair transplantation. Please see the attached photograph below. I did two sessions of hair transplant surgery on him and he was happy with the final results.

 

I prescribed oral minoxidil for hair loss treatment in less than 1% of patients in my practice over past 20 years. These are those hopeless patients who have the hair loss problem with no response from finasteride, dutasteride and minoxidil lotion but the patient wants to have some treatment option to treat the hair loss. I use it with caution, since there is no study regarding the dosage and safety in treating androgenic alopecia.

I do not prescribe this medicine to patients who are known to have cardiovascular disease, history of deranged blood pressure, liver and kidney dysfunction.

 

 

What is the optimal dose of oral minoxidil for the hair growth with minimal side effects?

 

I have learned from other physicians, who have prescribed minoxidil extensively to treat androgenic alopecia and was informed that 5 mg daily was enough to stimulate the hair growth without any effect on blood pressure and heart rate. One of my patients, who took oralminoxidil tablet and lives close by the clinic, came to the clinic twice a day for blood pressure monitoring for one month and all the reading were within the normal limits of his baseline; therefore, I am no longer monitoring the blood pressure as often as I did in the past. I have been using 5 mg daily for years and in some patient taken a low dose such as 2.5 mg tab per day or 5mg every other day still reported significant hair growth and stopped the hair loss to his satisfaction.

 

The most common side effect in my practice was puffy eyelids, leg swelling. Similar to any other forms of hair growth product, the gain hair will shed in 3-4 months on stopping the pill. This oral form should not be used in women due to hypertrichosis, it may persist in cases even on discontinuing the drug.

 

All of my patients were informed that the US FDA did not approve the use of oral minoxidil for hair growth and they have to take at their own risk, after understanding the risk and complications of the drug. I believe all the drug have side effects whether they are finasteride, dutasteride, spironolactone or dianee (for female hair loss). The long term treatment with oral minoxidil has more benefit than the chances of over said side effects at the low dose 2.5 - 5 mg once daily needs to be further studied. I advise the patient once the hair loss has stopped and experienced hair gained to stop oral minoxidil and switch back to minoxidil lotion for the long term maintenance usage. However, most of the patients did not want to switch to minoxidil lotion since there was no side effect noted. In some patient who switched to minoxidil lotion reported progressive hair loss.

 

I did not prescribe the diuretic as a routine since most of patients who experience water retention, refused to continue with this drug.Publications from Upjohn explicitly stated that a diuretic "must be" taken in conjunction with Loniten in most cases. The rationale is that while Loniten lowers blood pressure, your body's defense mechanism will automatically return your blood pressure to the original elevated level. Your body accomplishes that by retaining water and salt so that there will be more fluid to pump throughout the body. So in order for Loniten to be safe to consume, it is necessary to use a diuretic medication to remove excess water and salt from your body. Spironolactone is a natural choice for most hair loss sufferers since not only is Spironolactone a diuretic, it is also a potent anti-androgen.

 

In conclusion, only few percentage of the bald population in the world approaches the hair restoration clinics for the solution for hair loss. Of these there are many people who have marked social and emotional impact of hair loss in their lives thus, affecting their psychology. Most of these patients are very well benefited by the treatments like topical minoxidil, oral finasteride and the currently available artistic hair transplant surgeries offered by the clinics.

 

However there are number of patients, who are poor candidates for the hair transplant as they have poor donor area i.e. small donor area, thinning over donor area or have poor quality (more miniaturization at donor site) with large area of baldness NW-Class VII and searching for any possible hope that might improve their hair loss. These patients need to be emphasize regarding the side effects of oral minoxidiland with no FDA approval for hair loss indication. If patient consent's for this treatment, we propose to these terminal hair loss but high hoping patient that they might get benefit from opting to the oral minoxidil as the last sort of therapy till further new drug is available.

 

Best regards,

D. Pathomvanich MD FACS

[RCWest]

You are quoting what Dr. Pathomvanich said a while back on the subject. I've been using 5 mg. twice a day for right at a full year now. When I went back to Virginia last month to visit my parents they couldn't believe the difference in my hair. 5-10 mg a day isn't enough to really cause side effects, as they typically use 40-100 mg daily for blood pressure. I haven't had any side effects (no weight gain, heart palpitations, etc).

[Blake Bloxham]

You are quoting what Dr. Pathomvanich said a while back on the subject.

 

Yup! I've discussed the issue with him a few times via email and he was nice enough to write the above reply during one of the exchanges. He's an excellent physician and I think he did a good job summarizing his case for the use of oral minoxidil.

 

I've been using 5 mg. twice a day for right at a full year now. When I went back to Virginia last month to visit my parents they couldn't believe the difference in my hair. 5-10 mg a day isn't enough to really cause side effects, as they typically use 40-100 mg daily for blood pressure. I haven't had any side effects (no weight gain, heart palpitations, etc).

 

Thank you for sharing your personal experience!

Edited July 19, 2011 by Future_HT_Doc

[munchkinman]

Hi, thanks for your replies.

Future_HT_Doc- It was reading that post that has made me consider using oral minoxidil, after he stated the success of it, and I am hoping that used in combination with finasteride it can provide some good results, or at-least maintain what I have so that I can keep hiding it with concealer. Topical minoxidil is really not an option, I wish it was as I still have peach fuzz at my temples and I think it may thicken it up, but I don't want to risk my housemates detecting my use of concealer.

 

RCWest- You mean you have seen some good results from it? What is your hair loss pattern like? Also where do you source your oral minoxidil from?

[NorwoodBalding]

Hey munchkinman,

 

Where will you get your prescription from?

 

 

Future HT Doc,

 

Is it one tablet per day as it would be for Finasteride? If the results are remotely positive, doesn't that sound absolutely dreamy? And the slogan: Only two tabs a day to take your hair loss away!

 

Regards

Norwood

[rws]

Just to add my two cents, I've been taking Loniten (oral Minoxidil) 5mg twice a day since about February this year. To say the results are good is an understatement... I've had excellent results over the entire scalp with no side effects at all (except my cheeks becoming a little furrier - easily sorted with some tweezers!). I have my bloods monitored by my doctor, and my salt levels are within the normal range. I've also not experienced any weight gain or swelling. I'm not on a diuretic, but I'm on a good diet and include plenty of natural diuretic foods in my meals (asparagus, beetroot, coffee / tea, oats), which maybe helps.

 

I'm also on 1.25mg Finasteride daily, which has been great at preventing further hair loss - I've been on it for 7+ years now - but it's only since I started taking Loniten that I saw considerable regrowth rather than just prevention.

 

I looked into taking Spironolactone alongside Loniten, but there have been some carcinogenic effects reported in lab studies, which completely put me off. Right now I'm absolutely happy with how the Loniten is working, and I'm sticking with it.

 

From my personal experience it's been great, but I'd speak with a physician first, as it's a good idea to monitor your blood levels in the first couple of months to make sure everything's OK.

[RCWest]

rws, I'm glad to see it's working well for you. I've tried Spironolactone in the past. It really helps oily skin if you have it!

[greatjob]

For any of the members taking oral Minoxidildo you happen to have any before and after pictures? I'm curious whether or not I should give this a try. Also wondering how willing doctors in the states are to prescribing it.

[huhu]

I used for 6 months. It was useless and caused my body hair to grow

I was always feeling tired and my body was gaining weight

 

My advise don't use

If you think about concentration regaine has higher minoxidil than oral tablet which are 50mg and 5 mg respectively.

[rws]

50mg is a huge dose - I hope no one would consider that just for hair loss. I've been taking 10mg daily (2 x 5mg, morning and night) for about 9 months, and I've had good results with it. It has thickened the hair shafts all over my scalp and improved the density. I took it just after I had a FUE procedure (1500 grafts), and I believe it helped to minimise shock loss and cause quicker regrowth. It has made my body hair grow a little too, but nothing outlandish!

[Ukresponder]

I also used loniten (oral minoxidil) I started on 2.5, then 5, then 10mg per day, well below the maximum 100mg for treatment resistant Blood pressure.

 

i have to say it does def work, regrowth occured in the crown and good density thickening up. the issue for me was increased facial hair again under the cheeks and i also noticed more hair on my hands and ends of my wrists, became a little too wolf like for my liking, that was the only reason I gave it up.

 

No other side effects interms of cardiac ect.

 

I found out about it from a family Doctor who is now retired but back in the day when he was a full time GP he was telling me about a guy who simply could not get his blood pressure controlled and the last resort is loniten it is now hospital only for treatment resistant blood pressure, but way back when it first came out Gp's could use it.

 

Anyway what got me excited was that the patient was 50 years old and bald like Kojack, he came back 6 months later with JET black hair and the Doc quoates ' mushroom growth'!

 

I think there is def results to be had but at what financial cost and what side effect cost? I think that kind of response is from the high end of the dosage limit for controlling blood pressure, would you get those results from the 5-10mg being tried out as an adjunct to proven medicated therapy? It's unethical and too high a dose to ever get any raw empiracal data on and who knows what the long term effects wil ever be in normotensive patients?

 

It looks like it has a dose dependent efficay curve the more you take the more you get out of it but also the more sides will occur.

 

Get on the foam that will work with dermatch much better, or you have to get into a religious routine of waking your self up 2 hous b4 normal slapping it on so it can absorb then going about your normal routine, you should at least put it on before bed.

 

the foam will also not irritate your scalp and skin either.

 

the combined effect could be good with oral plus foam, who knows.........

 

 

UK r

Edited January 11, 2012 by Ukresponder
spelling

[johnny2000]

Any updates on This oral minox?

[johnny2000]

???hmmmm

[rws]

Quick update from me - I'm still on oral Minoxidil over three years later, and getting great results. I'm 'lucky' (in a double-edged sense) that I have to be treated for moderate hypertension as well, so my doctor is happy to prescribe it instead of the more common blood pressure meds in order to give me the BP and hair benefits. That means I don't have a problem getting it legitimately on prescription, although it's still not licensed orally for hair loss alone, so some people might have issues getting a prescription for it.

 

I was on 5mg twice a day for about two years, but I've just been stepped up to 10mg twice a day due to a rise in my BP. It wiill be interesting to see if that goes hand in hand with any noticeable difference in hair thickness.

 

The only real negative side effect for me is a hairy face - it makes the soft, downy hair around your cheeks and eyebrows grow in a lot darker, so be prepared to do a bit of face gardening if you're taking it! Otherwise, my scalp has benefitted - even with Regaine foam, I had a lot of scalp dryness. Now, I can just care for my hair normally without worrying about the mess that topical minox makes of it.

 

I've had two FUE procedures myself, and found the meds invaluable for both thickening up the donor areas pre-procedure, and creating a healthy environment for the transplanted grafts to grow afterwards. Personally I also feel it prevented shock loss - I never experienced this at all (although that could just be luck).

Edited June 24, 2014 by rws

[mpbasian]

hey, rws,

 

any chance you could post a pic of your facial growth? Are you naturally hairy on your face and body? I mean, able to grow a full beard and stuff. I suppose maintaining facial hair is way better than losing hair up top.

also..may I ask your age and what else you are taking?

I took proscar for a few days but I'm dropping it because the sides aren't worth the risk in my opinion.

Thanks for the updates!

[savemyhairplease]

I personally wouldn't use oral minox

[rws]

I think you're right to be wary and reluctant, @savemyhairplease - although I've had no problems myself, there's no getting away from the fact that it's a potent drug that has very concrete effects on your physiology. If I didn't have access to regular pathology / physician check-ups myself, it's not a route I'd have chosen either. It's just fortuitous (in a rather ironic sense!) that I also have hypertension, which responds very well to Loniten - it's taken me down from 160/100 to more like 130/80, which is a dramatic improvement. In my experience it's the perfect medication for those with both MPB and hypertension together - but a normal, healthy adult should exercise the utmost caution in considering it.

 

@mpbasian, I was already naturally a bit hairy. What oral minox has done is just to thicken / darken existing body / facial hair, sometimes turning invisible downy hairs (especially around the cheeks / eyebrows) into visible ones that need some attention! It's easy to deal with, though, and of course, it's done the same to my scalp hair too, which was the desired effect.

[johnny2000]

I think you're right to be wary and reluctant, @savemyhairplease - although I've had no problems myself, there's no getting away from the fact that it's a potent drug that has very concrete effects on your physiology. If I didn't have access to regular pathology / physician check-ups myself, it's not a route I'd have chosen either. It's just fortuitous (in a rather ironic sense!) that I also have hypertension, which responds very well to Loniten - it's taken me down from 160/100 to more like 130/80, which is a dramatic improvement. In my experience it's the perfect medication for those with both MPB and hypertension together - but a normal, healthy adult should exercise the utmost caution in considering it.

 

@mpbasian, I was already naturally a bit hairy. What oral minox has done is just to thicken / darken existing body / facial hair, sometimes turning invisible downy hairs (especially around the cheeks / eyebrows) into visible ones that need some attention! It's easy to deal with, though, and of course, it's done the same to my scalp hair too, which was the desired effect.

 

Any Update?

[rws]

Still happy and going fine on Loniten. My doc increased the dose from 10mg a day to 20mg (because of my BP, not my hair LOL!) and I think it's really strengthened the hair shafts. It's also increased the body hair effect, although this doesn't bother me (I was fairly hairy anyway!).

 

I realise not everyone can take it, being a serious BP drug, but if you already have BP issues and want to combine it with an attack on MPB too, it's a good way of killing two birds with one stone if your doc approves. I so much prefer it to rubbing Regaine in every day, and it seems so much more effective.

[johnny2000]

Still happy and going fine on Loniten. My doc increased the dose from 10mg a day to 20mg (because of my BP, not my hair LOL!) and I think it's really strengthened the hair shafts. It's also increased the body hair effect, although this doesn't bother me (I was fairly hairy anyway!).

 

I realise not everyone can take it, being a serious BP drug, but if you already have BP issues and want to combine it with an attack on MPB too, it's a good way of killing two birds with one stone if your doc approves. I so much prefer it to rubbing Regaine in every day, and it seems so much more effective.

 

I dont have BP issues so my doc Will not prescribe it to me.

I was thinking of buying it online and hopeing it would not get hold up in custom?

But if the regrowth is small or maybe nothing at all i dont know if i should do it?

 

Could you plssss post before and after pictures of your results ?

[fortune11]

reviving this old thread

 

I just had an FUE (Dr Ron Shapiro) and have started taking Loniten 2.5 mg daily per his recommendation, today is my first first day with it. He did make me aware of the sides and their frequency and it seemed reasonable parameters for me at this dosage.

 

For me it is an alternate to topical but now reading this thread and seeing how some people here have seen better growth with the oral version, I am hopeful that it will have an impact on my FUE recovery , esp in the recipient area where it has been a bit slow to bounce back even after ~ 2 weeks post surgery (the donor is regrowing just fine so far).

 

Will let you guys know what I see . FUE thread below for those interested.

 

https://www.hairrestorationnetwork.com/eve/185663-recent-fue-dr-ron-shapiro-prior-fut-patient.html