OMAHA EFFECT? Oral Minoxidil Alcohol Hangover Association

Oral Minoxidil Might Increase the Possibility of Alcohol Hangover.

If you are like me and never heard of the OMAHA effect, then read on!

Oral minoxidil is increasingly used for the treatment of hair loss. Authors from New York recently reported ten patients who used oral minoxidil and developed alcohol hangover symptoms with alcohol. These symptoms included nausea, headaches, and light sensitivity.

The authors note that an online interaction checker showed that alcohol and minoxidil do have a moderate interaction – because the two have an added effect on lowering blood pressure. I noted that when I checked drugs.com today, this same effect could be seen.

In this paper, the authors define an alcohol hangover as “a combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero.”  The authors remind us that symptoms of alcohol hangover might include headache, nausea, fatigue, dry mouth, third and may encompass fatigue, headaches, increased thirst, and dry mouth.

The authors point out that the exact mechanisms still need to be clarified. Still, there are suggestions in animal studies that oral minoxidil could affect how alcohol is metabolized in the gastrointestinal tract. Overall, the authors point out that this is not something that is seen with other blood pressure drugs. Specifically, they state that there have been no reports of other blood pressure-lowering drugs - particularly those with vasodilatory properties such as hydralazine or calcium channel blockers causing any exacerbating alcohol hangover symptoms.

The authors state that in their practice, they advise patients to refrain from taking their LDOM dose the day they anticipate excessive alcohol consumption. And they call for further research on the potential worsening of alcohol hangovers with oral minoxidil.

Why this study caught my attention?

This study caught my attention for two reasons. First, this is an interesting observation. Having been prescribed oral minoxidil for a long time, I’ve not seen or heard of this before. I’m going to keep watch and start asking patients.

Second, I’m surprised this article was accepted for publication without requiring more information. While the article reads beautifully, there is no quantitative information in this paper except for the number of patients the authors have seen report this effect. We don’t have information on who these patients are, what doses they took, what symptoms of alcohol hangover they had, how long the symptoms lasted, or how sick patients were. I’ve reread the paper multiple times to see if I missed it. I didn’t - there is nothing in here. I think new, potentially practice-changing observations require that journal editors demand more.

Nevertheless, you can be assured that I’ll consider the OMAHA effect when I see my patients today.

REFERENCE

Lina Alhanshali 1, Deesha Desai 2 3, Ambika Nohria 3, Jerry Shapiro 3, Kristen Lo Sicco 3. Oral minoxidil and the exacerbation of alcohol hangover symptoms. Affiliations expanInt J Dermatol . 2024 Apr 21. doi: 10.1111/ijd.17195. Online ahead of print.