Low Dose Oral Minoxidil and Oral Spironolactone: Do they Lower Blood Pressure that Much?

Oral Minoxidil and Oral Spironolactone Do Lower Blood Pressure Just Not That Much

Low dose oral minoxidil (0.25 mg to 5 mg) and oral spironolactone (50-200 mg) are two hair growth medications that have the potential to lower blood pressure. Low dose oral minoxidil is used in a wide range of different hair loss conditions in both men and women. It is off label meaning that it is not formally FDA approved. Spironolactone is also off label and used for the treatment of androgenetic hair loss in women.

There is concern by some that use these blood pressure medications may lower blood pressure to dangerous levels. While oral minoxidil and spironolactone certainly can lower blood pressure, for the vast majority of patients, the blood pressure changes are quite minimal and much smaller than the typical changes in blood pressure that most humans will experience during daily living.

Low dose oral minoxidil can change blood pressure by 2 to 3 mmHg and spironolactone can change blood pressure by about 2-3.5 mmHg as well.

It is interesting that normal sleeping is associated with a drop in blood pressure by about 10 to 15 mmHg. This is clearly a much more dramatic change than the 2-3 mm Hg with oral minoxidil or oral spironolactone. Daily exercise can increase blood pressure by 20 to even up to 80 mmHg. The hours after exercise are associated with a surprising further reduction in blood pressure below the normal baseline. So exercise increases and then decreases blood pressure.

One can see that there are incredibly large fluctuations in blood pressure normally experienced by human beings during the day. The small changes blood pressure caused by oral minoxidil or oral spironolactone are insignificant for most patients.

There are some patients, however, who are extremely sensitive to these small changes in blood pressure and may not tolerate these medications very well. In addition, patients with heart disease must be careful not to decrease blood pressure below a set threshold so use of these medications requires special care and caution in these groups and may not always be recommended.