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Low Dose Oral Minoxidil Safety


Curious25

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I have been fascinated watching this trend unfold over the last 12-18 months, and it has certainly seemed to have gained an increase momentum in hair loss doctors now prescribing this. Interestingly enough, I’ve always picked up on these docs seemingly reluctant to be too joyous about admitting they prescribe it to some of their patients - a good example is the way Dr Nadimi addressed it during hers and Dr Konior’s Instagram LIVE session with Melvin. 
 

I’m going to link two videos from some  hair loss youtubers who have conflicting views on the safety of oral minoxidil. If anyone isn’t familiar with the Irish chemist guy, he is particularly hard to watch, as he comes across very patronising and just well, a bit weird and creepy in his vids. He claims to be a chemist anyway, and also claims splitting pills of proscar or propecia/finasteride to reduce the efficacy which may be a note of interest for some users on here who do so? 
 

 

So what are peoples thoughts? Those who use it . . How do you find it? Those who don’t, would you be interested in starting ? 

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I liked your observation about the chemist, thought it was just me that thought that ;) At least I would hypothesise that they have a higher risk tolerance - both having multiple surgeries at a younger age.

This is also interesting. "Although minoxidil is poorly absorbed through the skin, systemic doses in the range of 2.4 to 5.4 mg/day can be anticipated if application is made to entire scalp." https://jamanetwork.com/journals/jamadermatology/article-abstract/545803

I didn't think anything of side-effects when I used rogaine to good success several years ago. I weaned myself off mainly due to convenience and adherence. I started up again last year to improve my situation once deciding to go the surgery route after a relatively stable situation from finasteride for 10 years. I have however definitely experienced possible systemic side-effects - low-level headaches daily, higher resting pulse by about 5 beats (likely attributable to lowering blood pressure). If the study I shared holds some truth, along with my recent experience, there would be little difference in taking oral minoxidil at low doses. Definitely appealing based on the convenience, though with heart issues in my family, and limited access to such a prescription in my country, I don't think it is something for me right now.

I also think it is worth noting that we need to understand the systemic difference between topical and oral, in order to understand the benefits vs risks. If they are indeed actually rather comparable, this opens things up to oral being more convenient.

Edited by j1mmy
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The most prominent side effect from oral minoxidil is hypertrichosis. Very rare side effects include edema and even more rare, pericardial effusion. The doses for these rare side effects are much higher than the standard 1mg to 5mg dose that I've seen being used for treating MPB. I haven't seen these rare side effects in my patients. I won't prescribe oral minoxidil for underlying cardiac conditions such as CHF. In addition, I get a baseline EKG as well to watch out for any arrhythmias. 

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My advice does not constitute a patient-physician relationship nor as medical advice and all medical questions/concerns should be addressed to your medical provider. 

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50 minutes ago, lexzeus said:

I've been taking oral minoxidil for over 2 years (2.5mg) no side effects whatsoever and great results. My hair got much thicker. 

Awesome man . . Any regrowth? Or just general thickening of your native hair ? 

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Lol, I also find "The Hair Chemist" to be a little unsettling.

I don't think there's enough evidence for him to promote oral minoxidil so much.. I felt that Kevin Mann raised some great points. I'm also skeptical of his claims that you shouldn't split tablets, and that brand name is superior to generics.

What did Dr. Nadimi say exactly?

For the record I am on oral minoxidil for the past 2 months, 1.25mg morning + continuing with topical at night. I'd like to increase up to 2.5mg (perhaps 1.25mg twice a day) after another month and finally get off of the topical. I decided to get on it because I'm a diffuse thinner, never noticed any benefit from topical minoxidil, and it's a pain in the ass. Can't say I'm noticed any improvements yet. I did have side effects for the first couple of days - I felt tingling in my feet (pedal edema) when I went to bed (took it at night for the first month). Haven't experienced any side effects since.

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Has the edema subsided despite continuing with the drug? 
 

This something the chemist guy claims, he got all the sides eg. Facial swelling, tachycardia, head aches, yet they went away once his body became ‘accustomed’ to the drug? 

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7 hours ago, giegnosiganoe said:

Lol, I also find "The Hair Chemist" to be a little unsettling.

I don't think there's enough evidence for him to promote oral minoxidil so much.. I felt that Kevin Mann raised some great points. I'm also skeptical of his claims that you shouldn't split tablets, and that brand name is superior to generics.

What did Dr. Nadimi say exactly?

For the record I am on oral minoxidil for the past 2 months, 1.25mg morning + continuing with topical at night. I'd like to increase up to 2.5mg (perhaps 1.25mg twice a day) after another month and finally get off of the topical. I decided to get on it because I'm a diffuse thinner, never noticed any benefit from topical minoxidil, and it's a pain in the ass. Can't say I'm noticed any improvements yet. I did have side effects for the first couple of days - I felt tingling in my feet (pedal edema) when I went to bed (took it at night for the first month). Haven't experienced any side effects since.

RE. Nadimi, it’s around about the 32m30 mark on the insta live. I could just be reading into it, but I felt her body language pretty cagey on the topic ... looked away from the camera a lot, and bought up side effects without prompt, and kind of brushed it off, again not making eye contact, saying you can just stop taking it if you experience any. 

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5 minutes ago, Curious25 said:

Has the edema subsided despite continuing with the drug? 
 

This something the chemist guy claims, he got all the sides eg. Facial swelling, tachycardia, head aches, yet they went away once his body became ‘accustomed’ to the drug? 

Yes it has subsided, it was only for the first two nights. Nothing since. I'll see if there are any changes once I up the dose.

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I tried oral minoxidil briefly about 17-18 months ago following the guidance of a highly regarded HT doctor. 5mg every day (went to 5mg every other day after a while to see if sides would go). Must have been on it for no longer than a month (I can't remember exactly how long though). Not here to scare people off as it genuinely works for some people (as can be seen by many different case studies) with little to no side effects. But in my experience I experienced 3 significant side effects:

  1. Substantial Heart Rate Increase - When I'm not doing anything intensive my heart rate is anything between 60-75 bpm. On minoxidil tablets my heart rate went up between 80-115 bpm during the same type of activity, usually with great fluctuation. It remember it went up as high as 162 bpm during a presentation I had to do. I reckon emotions (stress mainly) play a significant part of the high bpm periods but for me it was still very concerning how oral minoxidil exacerbated this. In case anyone is curious, I didn't experience noticeable heart palpitations but did experience periods of irregular heartbeat.
  2. Stiff Lower Back - Could have possibly been related to the kidneys. Difficult to state if there is a direct relation with oral minoxidil but there was no stiffness before I was taking the tablets. The stiffness went away after I stopped taking them.
  3. Chest tightness - Developed what could be described as tightness to the chest whilst on oral minoxidil. Sometimes it was just a general light tightness across the chest, other times it was an intense burst of tightness on the left side of my chest. General light tightness went away pretty soon after I stopped taking the tablets but it took a couple of months or so after I stopped taking oral minoxidil for the intense bursts to go away. I no longer experience them anymore.

Again, I don't want to scare people off as there are genuinely excellent HT Doctors who are prescribing oral minoxidil as well as there being many positive case studies on its use for hair loss. But I feel like its important to add my experiences with it so people can make a more informed review-led decision on it.

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11 minutes ago, Nounours said:

as there are genuinely excellent HT Doctors who are prescribing oral minoxidil as well as there being many positive case studies on its use for hair loss

I fear this may be one of the oversights - they are cosmetic surgeons/dermatologists prescribing a pretty severe cardiac medication (granted at lower doses). 

I don't agree with all of Kevin Mcann's viewpoints, however I think he's pretty rational and even responsible in his Oral Minoxidil video. It speaks louder to me due to the fact that he is clearly a guy who is very passionate about maintaing and having the best head of hair that he can, and is not exactly risk averse to medication because he is a big advocate of propecia. 

Edited by Curious25
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On 4/25/2021 at 10:06 PM, Curious25 said:

Awesome man . . Any regrowth? Or just general thickening of your native hair ? 

For me it was just mainly thickening but it really depends on the level of hair loss you progression you are at 

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On 4/26/2021 at 11:13 AM, Nounours said:

I tried oral minoxidil briefly about 17-18 months ago following the guidance of a highly regarded HT doctor. 5mg every day (went to 5mg every other day after a while to see if sides would go). Must have been on it for no longer than a month (I can't remember exactly how long though). Not here to scare people off as it genuinely works for some people (as can be seen by many different case studies) with little to no side effects. But in my experience I experienced 3 significant side effects:

  1. Substantial Heart Rate Increase - When I'm not doing anything intensive my heart rate is anything between 60-75 bpm. On minoxidil tablets my heart rate went up between 80-115 bpm during the same type of activity, usually with great fluctuation. It remember it went up as high as 162 bpm during a presentation I had to do. I reckon emotions (stress mainly) play a significant part of the high bpm periods but for me it was still very concerning how oral minoxidil exacerbated this. In case anyone is curious, I didn't experience noticeable heart palpitations but did experience periods of irregular heartbeat.
  2. Stiff Lower Back - Could have possibly been related to the kidneys. Difficult to state if there is a direct relation with oral minoxidil but there was no stiffness before I was taking the tablets. The stiffness went away after I stopped taking them.
  3. Chest tightness - Developed what could be described as tightness to the chest whilst on oral minoxidil. Sometimes it was just a general light tightness across the chest, other times it was an intense burst of tightness on the left side of my chest. General light tightness went away pretty soon after I stopped taking the tablets but it took a couple of months or so after I stopped taking oral minoxidil for the intense bursts to go away. I no longer experience them anymore.

Again, I don't want to scare people off as there are genuinely excellent HT Doctors who are prescribing oral minoxidil as well as there being many positive case studies on its use for hair loss. But I feel like its important to add my experiences with it so people can make a more informed review-led decision on it.

5mg is way way too much. My HT doctor with 16+ years of experience only prescribes 1.25 mg daily ( break the 5mg tablet into 4 pieces )  I have been taking 2.5mg daily(due to my hair loss progression) for the past 2 years with 0 side effects and also includes taking high stim pre workout gym supplements. No way would I take 5mg daily !

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22 minutes ago, lexzeus said:

5mg is way way too much. My HT doctor with 16+ years of experience only prescribes 1.25 mg daily ( break the 5mg tablet into 4 pieces )  I have been taking 2.5mg daily(due to my hair loss progression) for the past 2 years with 0 side effects and also includes taking high stim pre workout gym supplements. No way would I take 5mg daily !

You're most probably right there! 5mg was too much for me at least. I guess it was just a case of listening to what the HT doctor (recommended by the forum and probably one of best in the industry) was saying and going with it as I trusted their judgement on it.

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I’ve been on Oral Minoxidil 2.5 mg for almost 3 months. No side effects. My hair has definitely gone through a big shed and looks worse. Fingers crossed that’s a good sign it’s working and will start to thicken up. 

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On 5/1/2021 at 7:46 AM, Style22 said:

I’ve been on Oral Minoxidil 2.5 mg for almost 3 months. No side effects. My hair has definitely gone through a big shed and looks worse. Fingers crossed that’s a good sign it’s working and will start to thicken up. 

Were you on topical minoxidil before that?

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13 minutes ago, Style22 said:

Yes was using the foam in the crown. No response with that. 

I'm a little surprised you'd still get a big shed then, but I guess that makes sense if you weren't responsive to the topical at all.

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Hello, I would have one question. Do you think it still could be effective (oral min) if I’d take it only 4 times a week with my finasteride (Monday Wednesday Friday Sunday) at the dose of 1.25/2.5mg ? Does someone have some suggestions?

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On 12/5/2021 at 12:06 AM, Whufcdanny95 said:

Anyone combining topical min with oral min?

me in past.
3,75 mg oral + 6 ml/5% topical.
I got bored to use topical so I switched to 5 mg oral.
I had goos results from topical but I can assure you that oral send topical to bed.

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