Safety and Effectiveness
Minoxidil was originally used at higher doses to treat high blood pressure. When it was realized that stimulating hair growth was an unexpected side effect, Rogaine® was developed as a safer alternative, since it is not absorbed unless you use more than a capful per night. However, Rogaine foam is a hassle.
More recently, low-dose oral minoxidil has been proven to be safe even for people with normal to low blood pressure. It has been shown to re-grow hair and is easier for patients to use than topical Rogaine.
Side Effects
Side effects are reversible with drug discontinuation.
- Hair growth in areas you don’t want hair, like other parts of the face, arms, and legs.
- Swelling, including in the face. This is not a dangerous type of swelling or an allergic reaction. It’s just a puffy face and legs, which can be managed with support stockings. However, if you don’t want to wear support socks, you should not continue to take minoxidil if your legs swell.
- Early hair shedding. This is actually a good thing, as the formation of new, actively growing hairs dislodges wimpy, loose hairs.
- Extremely rare reports of inflammation of the heart, heart rhythm issues, and fluid collecting around the heart. If you develop chest pain or shortness of breath, stop minoxidil and go to the ER.
What to Expect
Positive hair growth is seen in the majority of patients. It takes 2–3 months to start seeing improvements and 6 months before you can really be sure if it’s working or not. If you find that it works for you, it needs to be continued indefinitely. If you do not see any improvement in 6 months, you can stop it without having a big shedding event. When you stop, you will only shed the hairs it grew for you. You will not lose all your hair.
No medication is going to regrow all of your hair. Everyone’s response is different. The most improvement is seen when you go from no minoxidil to 2.5 mg. Going up to 5 mg or 10 mg does help a little more, but with potentially more side effects.
How to Take It
- Take it in the morning.
- If it lowers your blood pressure, you can compensate by drinking more water.
- Minoxidil is only available in 2.5 mg or 10 mg tablets. To get a 5 mg dose, we can either prescribe 2 of the 2.5 mg tablets, or you can cut the 10 mg tablets in half.
- Get a blood pressure cuff.
- Continue to monitor blood pressure at home. Ideal blood pressure is 120/80. Many people are above that level, so there may be an additional benefit of controlling mildly elevated blood pressure.
Have questions about oral minoxidil, or want to talk through your hair loss options? You can book online or call the office at 423-528-8833. This page is for general education, not a substitute for a personal exam.