Reduced Minoxidil Dosage and Shed - Advice Needed

[Leftwithrope]

Hey guys,

I recently reduced my oral minoxidil dosage from 10mg to 5mg, and was shocked to see that shedding of the minoxidil-dependent hairs has begun within a week.

I'm wondering if any of you here who use Minoxidil might be able to share your experiences with reducing your dosage. 

Is it common for sheds to happen when reducing the dose and would there be a good chance that I'll get my previous regrowth if I increase the dose again?

Thanks and really really hoping to get some advice.

 

[gillenator]

Cutting your dose in half is significant IMHO....you certainly can try to go back to your original strength and then work down in smaller increments.

You may find that once the shedding starts, there is little that can be done to stop it until the cycle is completed.

[ciaus]

 

So from what little I know about oral minoxidil, 40-60mg is the strength range for its original purpose -treating high blood pressure. For the propecia-like reduced strength that will give you the hair loss prevention benefits, the dosages I'm seeing generally go up to only 2.5mg -that's two-point-five, not 25.

 

I've been thinking about starting oral minoxidil because I have sensitive scalp skin due to seborrheic dermatitis that is easily irritated by some of the ingredients in the topical minixodil formulations, like alcohol. I'm in the USA and talked with my doctor and he's offering to write me a script for 2.5mg pills cut in two, so essentially it would be a 1.25mg dosage per day. I've read in doses starting around 2.5 mg some might notice a slight increase in their heart rate so I'd be careful about the 5mg and 10mg doses -unless you do actually have elevated blood pressure.

 

But to your question about dosage and shedding, does the same company that made the 10mg pills also make the 5mg pills? Could be a potency, production issue, check with your pharmacy.

And have you started to take regular doses of aspirin for anything or any other changes in your life around this time health wise? -Check this out on the effects of aspirin on minoxidil - https://donovanmedical.com/hair-blog/asa-minoxidil

 

And here are some other interesting reads for anyone:

https://donovanmedical.com/hair-blog/side-effects-of-lowdose-minoxidil

https://www.practiceupdate.com/content/minoxidil-1-mg-orally-vs-minoxidil-5-solution-topically-for-the-treatment-of-female-pattern-hair-loss/88782
from the Journal of the American Academy of Dermatology

https://hairverse.com/oral-minoxidil/

[Leftwithrope]

 

On 8/8/2020 at 7:50 AM, gillenator said:

Cutting your dose in half is significant IMHO....you certainly can try to go back to your original strength and then work down in smaller increments.

You may find that once the shedding starts, there is little that can be done to stop it until the cycle is completed.

Hi Gillenator,

Thank you for your advice.

Would you happen to know if there are any adverse effects if I suddenly increase/decrease the dose of a medication (Minoxidil in this case) in the midst of a shed? I believe Minoxidil works by instructing telogen hairs to shed immediately and to begin the anagen process. 

I am worried that adjusting the dose while shedding would somehow result in complications for the regrowth process (I'm rather paranoid now), and would love to hear what you think about it.

Thank you,

Sean

[Leftwithrope]

On 8/8/2020 at 8:41 AM, ciaus said:

 

So from what little I know about oral minoxidil, 40-60mg is the strength range for its original purpose -treating high blood pressure. For the propecia-like reduced strength that will give you the hair loss prevention benefits, the dosages I'm seeing generally go up to only 2.5mg -that's two-point-five, not 25.

 

I've been thinking about starting oral minoxidil because I have sensitive scalp skin due to seborrheic dermatitis that is easily irritated by some of the ingredients in the topical minixodil formulations, like alcohol. I'm in the USA and talked with my doctor and he's offering to write me a script for 2.5mg pills cut in two, so essentially it would be a 1.25mg dosage per day. I've read in doses starting around 2.5 mg some might notice a slight increase in their heart rate so I'd be careful about the 5mg and 10mg doses -unless you do actually have elevated blood pressure.

 

But to your question about dosage and shedding, does the same company that made the 10mg pills also make the 5mg pills? Could be a potency, production issue, check with your pharmacy.

And have you started to take regular doses of aspirin for anything or any other changes in your life around this time health wise? -Check this out on the effects of aspirin on minoxidil - https://donovanmedical.com/hair-blog/asa-minoxidil

 

And here are some other interesting reads for anyone:

https://donovanmedical.com/hair-blog/side-effects-of-lowdose-minoxidil

https://www.practiceupdate.com/content/minoxidil-1-mg-orally-vs-minoxidil-5-solution-topically-for-the-treatment-of-female-pattern-hair-loss/88782
from the Journal of the American Academy of Dermatology

https://hairverse.com/oral-minoxidil/

Hey Claus,

Thank you for your reply.

From my experience, oral minoxidil doesn't have a noticeable effect on blood pressure and resting heart rate at 5mg and below.

I'm a Chinese male, 5"11 and 143lbs, and am living a rather sedentary lifestyle. I started off at 5mg and did not feel any adverse effects apart from strange sensations on some of my fingers ( probably from increased blood flow from the drug) which subsided after a week or two.

I took 5mg for a year without any problems whatsoever but things changed when I ran out of the pills and resorted to drinking topical Kirkland Minoxidil because of COVID-19 shipping delays. From my research around forums, 0.1ml of 5% Minoxidil solution would give me the equivalent of a 5mg oral dosage, but somehow I was beginning to feel side effects like shortness of breath and most alarmingly, problems with getting hard. 

I'm honestly not sure if it was the method of delivery or the likelihood of an increased dosage that caused my erectile issues, but the issue seemed to continue after I started taking 10mg pills. I remember the sexual sides only started after I started to drink liquid Minoxidil because I was always able to enjoy pornography throughout my time on the 5mg pill.

I will cease taking 10mg doses once the 5mg pills arrive, as the effects on my heart are really noticeable.

Oral minoxidil is a really powerful drug when taken in conjunction with finasteride, but 5mg should really be the upper limit for what I would consider a relatively safe dosage. With 5mg oral minoxidil, I was able to turn weak vellus hairs on my head to intermediate/almost terminal hairs which is fucking amazing. 10mg will probably strengthen them to be on par with terminal hairs, but I am just not willing to risk being on that dose for the long run.

About your questions, the 5mg pills I previously took was from AllDayChemist and manufactured under the name Lonitab by Intas, an Indian manufacturer. My 10mg pills were ordered from InhousePharmacy and are manufactured under the name Loniten by Pfizer. Both versions are definitely legitimate, but I won't rule out the possibility of a difference in potency arising from production issues.

I've never taken aspirin in my life but have heard about it nullifying the effects of Minoxidil.

Definitely give 2.5mg a try and see how it works out for you after 6 months. If you experience any undesirable sides at that dosage, then it would be unwise to increase it.

Regards,

Sean

 

[Leftwithrope]

To anyone out there who stumbles upon this thread,

Would you be able to share if it is advisable to adjust the dosage of minoxidil in the midst of a shed?

I understand I'm part of a minority that takes the drug orally, but this should really be no different from someone asking about changing the strength of their Rogaine solution. 

My primary concern is that the sudden reduction of signaling strength to the follicles would result in one of those dreaded extended shedding phases, because the follicles are never able to adapt to a consistent dose. 

Would REALLY appreciate anyone's thoughts, opinions or advice on this!

@Melvin-Moderator@spex@JayLDD

Edited August 12, 2020 by Leftwithrope

[Melvin- Admin]

How long have you been experiencing a shed? I would tough it out.

[ciaus]

5 hours ago, Leftwithrope said:

but things changed when I ran out of the pills and resorted to drinking topical Kirkland Minoxidil 

 

Whoa, had to stop when I read that and check out Kirkland's Minoxidil label -this image here is from Costco's website, they own the Kirkland brand, read that warning I've highlighted below.

Is this what you are drinking? This topical formulation is different from the oral pill. If so I would recommend you stop and check with a doctor, let them know how long you've been taking it, symptoms you've had, and see what they think about any kind of possible permanent damage you may have sustained.

 

[Leftwithrope]

46 minutes ago, Melvin-Moderator said:

How long have you been experiencing a shed? I would tough it out.

Hey Melvin,

I started shedding after going back on oral minoxidil pills. I went from what I assume to be 5mg oral minoxidil in liquid form to half a 10mg pill (might not be exactly 5mg as I used a pill cutter). Was drinking liquid minoxidil for 2 months before my pills arrived.

I increased my dose to 10mg 5 days ago because I was worried my pill cutter was giving me inconsistent dosage every time, and I would rather go for a consistent dose even if it was higher.

I'm going to keep taking 10mg till my 5mg pills come in about a month.

Definitely going to tough this one out but am not sure if a sudden shift in dosage after a shed might prolong it or have any negative implications.

Would love to hear your thoughts or experiences.

Regards,

Sean

[Leftwithrope]

59 minutes ago, ciaus said:

 

Whoa, had to stop when I read that and check out Kirkland's Minoxidil label -this image here is from Costco's website, they own the Kirkland brand, read that warning I've highlighted below.

Is this what you are drinking? This topical formulation is different from the oral pill. If so I would recommend you stop and check with a doctor, let them know how long you've been taking it, symptoms you've had, and see what they think about any kind of possible permanent damage you may have sustained.

 

Hey Ciaus,

Thanks for the reply.

The ingredients of Kirkland Minoxidil are Minoxidil, alcohol, propylene glycol and water - all of which do not cause harm to the body unless taken in excessive amounts or if one has an allergy to any of them. People who do drink topical minoxidil from the bottle usually drink no more than 4-5 droplets of the solution.

Do really try to avoid going above 5mg if you ever try oral minoxidil. I know of quite a number of people in the HairLossTalk forums who go up to 20mg and that's pretty insane.

@jjsrader

Hey JJ, just remembered you were one of the people on HRN who is on oral minoxidil as well. Would you be able to share if oral minoxidil has caused you any issues with getting it up too?

Thank you.

Edited August 12, 2020 by Leftwithrope

[ciaus]

Ok thanks for the advice about the oral minox, sorry can't be of help with dosage changes and sheds, good luck!

[jjsrader]

Hi,

I never had any erectile issues.

I believe I may have had elevated heart rate about 6 months ago (or I'm just fat and out of shape when walking or biking up a hill) - regardless - I settled on long term 5mg per day 1X per day.

I figured that was reasonable for the long term.  I've had many surgeries w/another 1 or 2 more to go in the next 5 years & have very fine - very straight hair - so oral minox was never going to be something that really changed anything in a great way either or.

Without surgeries I would easily be a NW 5+ - so I just switched over to oral minox a few years ago 'cause I hated liquid minox, which I was having compounded at 30% cream at Murray Apothecary having worked my way up from 5% over the decades.

Edited August 12, 2020 by jjsrader
more clarity

[Leftwithrope]

3 minutes ago, jjsrader said:

Hi,

I never had any erectile issues.

I believe I may have had elevated heart rate about 6 months ago (or I'm just fat and out of shape when walking or biking up a hill) - regardless - I settled on long term 5mg per day 1X per day.

I figured that was reasonable for the long term.  I've had many surgeries w/another 1 or 2 more to go in the next 5 years & have very fine - very straight hair - so oral minox was never going to be something that really changed anything in a great way either or.

Without surgeries I would easily be a NW 5+ - so I just switched over to oral minox a few years ago 'cause I hated liquid minox, which I was having compounded at 30% cream at Murray Apothecary having worked my way up from 5% over the decades.

Thanks for the response, JJ.

You were on 20mg a day previously if I recall correctly. Did you experience any kind of sheds going down to 5mg?

How's your donor area coming along after so many surgeries?

[jjsrader]

I've had all FUT's (100, 120, 400, 700, 2,250 & 4500) & one FUE (500) grafts.  I need scar revision for my last 4500 FUT.  I don't know if I had a shed or not - I was on 20mg for only 3 months or so w/10mgs 2X's per day.  I then went down to 10mg 1X per day and now have been on 5mg 1X per day for at least 6 months.

For my last surgeries I'll do FUE spread out over entire donor area even into near temples - w/alot less FUE near my scars (obviously).  We'll see.  With Co-Vid I'm not really thinking of doing another surgery until probably mid-to-late 2021.

[gillenator]

On 8/12/2020 at 4:41 AM, Leftwithrope said:

 

Hi Gillenator,

Thank you for your advice.

Would you happen to know if there are any adverse effects if I suddenly increase/decrease the dose of a medication (Minoxidil in this case) in the midst of a shed? I believe Minoxidil works by instructing telogen hairs to shed immediately and to begin the anagen process. 

I am worried that adjusting the dose while shedding would somehow result in complications for the regrowth process (I'm rather paranoid now), and would love to hear what you think about it.

Thank you,

Sean

You're very welcome Sean...now here's the thing, any significant change in hair loss medications can potentially cause hair follicles to retreat into the telogen phase....this includes an abrupt hault...the same thing can occur with finasteride....this is why I usually recommend that medications are introduced in a gradual manner...why?...because too many times I have heard from various guys or seen their posts having experienced acute shedding from significant changes in their hair loss meds...IMHO, it was the fact that you "lowered" the amount of minoxidil by half that probably induced the shed...by increasing it back won't have a bearing because the shed is already in place.

Keep in mind once the shedding starts, it's nearly impossible to stop it or reverse it....this is because numerous hair follicles have already gone into the dormant phase where they will rest for 3-4 months before entering a new growth phase.

Yes minoxidil has shown to stimulate dormant follicles into a new growth phase and also improve hair shaft diameter.

The best thing to do is to discuss this with your doctor because you want to follow their post-op instructions to a T and they will provide what to take and the proper dosage.

I am simply sharing my own observations of a countless number of guys who have significantly adjusted their hair loss medications and then wondered why a significant shed resulted.