Oral Minoxidil for Hair Loss Patients with High Blood Pressure

Can oral minoxidil be used in patients with high blood pressure who use blood pressure drugs?

Well, a new study suggests it’s often okay. The study set out to evaluate whether or not oral minoxidil can be used safely used in most patients with hypertension.  

The study was a retrospective study of patients with hypertension or arrhythmia treated with LDOM.   There were 254 patients with hypertension in the study. This included 176 women and 78 men. The mean age of 56.9 years. Patients were receiving between 0 and 5 antihypertensive drugs. 58.9% of patients were using one blood pressure drug. 32.7% were on 2 drugs, 7.1 % were on 3 or more.   The mean dose of LDOM was 1.59 mg.

All in all, systemic side effects were detected in 6.8% of cases . This included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%). LDOM needed be stopped in 6 cases (1.5%).

Patients who received 3 or more antihypertensive drugs and those using doxazocin (an alpha an alpha-adrenergic blocker) were more likely to need to stop their drug. In fact, patients who received 3 or more antihypertensive drugs also had a higher risk of developing more than 1 side effect, lightheadedness, general malaise.

For the most part, patients with high blood pressure tolerated oral minoxidil fairly similarly to patients in the general population.  The authors proposed there was just a slightly higher incidence of systemic side effects, light-headedness, fluid retention in those with hypertension but it was just a slight increase.

This is an interesting study.  The authors propose that most patients with hypertension can start LDOM without referral to a cardiologist.  Starting the dose at bedtime may limit the chances of postural hypotension The authors propose that caution is warranted in those using 3 or more drugs, those using the drug doxazocin and those with uncontrolled hypertension or arrythmia. These patients may benefit from referral to a cardiologist as well as  baseline EKG and proper monitoring of  pressure measurements at home in the first few days and weeks of starting (and any dose adjustment)

The authors propose that some patients should not start LDOM at all including those with prior heart attacks, heart failure, valvular disease, pericardial disease and kidney disease. These patients are probably not candidates at all but consultation with a cardiologist is necessarily.

REFERENCE

Jimenez-Cauhe J  et al. Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients. Actas Dermosifiliogr. 2023 Aug 29:S0001-7310(23)00679-8.