Month: January 2023

Pharmacology and therapeutics
Female pattern hair loss: a pilot study investigating
combination therapy with low-dose oral minoxidil and
spironolactone
Rodney D. Sinclair1,2, MBBS, MD, FACD

Abstract
Background Minoxidil and spironolactone are oral antihypertensives known to stimulate hair growth. Objective To report on a case series of women with pattern hair loss (PHL) treated with once daily minoxidil 0.25 mg and spironolactone 25 mg. Methods Women newly diagnosed with a Sinclair stage 2–5 PHL were scored for hair shedding and hair density before and after 12 months of treatment with oral minoxidil 0.25 mg and spironolactone 25 mg. Results A total of 100 women were included in this observational pilot study. Mean age was 48.44 years (range 18–80). Mean hair loss severity at baseline was Sinclair 2.79 (range 2– 5). Mean hair shedding score at baseline was 4.82. Mean duration of diagnosis was 6.5 years (range 0.5–30). Mean reduction in hair loss severity score was 0.85 at 6 months and 1.3 at 12 months. Mean reduction in hair shedding score was 2.3 at 6 months and 2.6 at 12 months. Mean change in blood pressure was 4.52 mmHg systolic and 6.48 mmHg diastolic. Side effects were seen in eight women but were generally mild. No patients developed hyperkalemia or any other blood test abnormality. Six of these women continued treatment, and two women who developed urticaria discontinued treatment. Limitations Prospective, uncontrolled, open-label observational study. Discussion Once daily capsules containing minoxidil 0.25 mg and spironolactone 25 mg appear to be safe and effective in the treatment of FPHL. Placebo-controlled

My derm prescribed me 1mg oral minoxidil as they wanted to evaluate the effects of the drug for a month before they increase the dose. I am wondering if 1mg is effective enough and if anyone has seen results when taking 1mg? I currently use topical minoxidil 2 times a day.

Since 60% of men will not respond to topical minoxidil, the oral works on 100% of men. The 1mg dose is a reasonable starting dose. Your dermatologist knows what she is doing.

I have been a long time fin user and recent Dutasteride user for the last few months. I’ve already spoken to the guy that’s done my dysport for years about trying oral minoxidil. I’m not interested in using it topically and have read some really encouraging and really recent literature lately on low dose oral Min for MAA. Is this a reasonable option?

Oral minoxidil can be very effective and is a good alternative to finasteride

A recent report out of South Africa showed a healthy woman placed on 0.25mgs of oral minoxidil developed cardiac and other systemic swelling. This situation could have been life threatening, but it was picked up early and the medication was stopped. The problems went away.

Up until this point in time, I, like most of my colleagues believed that dosing oral minoxidil of 2.5 mgs/day or lower did not expose the risk of cardiac complications. This is the first such reported case of what may be thousands of people, but this post is here to let you know if you are on oral minoxidil that this is a risk.

Of significance, this patient had signs of a problem with swelling of the legs, hands and face and her doctor was quick to discontinue the drug with reversal of all side effects , so if you get swelling of your hand, feet face, speak with your doctor and consider stopping the minoxidil.

But does oral min have potentially less catastrophic or permanent side effects then what finasteride can allegedly have in some select people?

This is the reason each and every person being prescribed a medication needs a doctor. I can’t give you assurance that any drug is absolutely safe. Read the drug information that is easily supplied on the internet and then you must make a judgment with your doctor on what you want to do.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678755/

Please note the following statement in the article:

” Since the original introduction of low-dose oral minoxidil for this indication, reported adverse effects have been purported to be infrequent and of minor impact, with 15.1% hypertrichosis, 1.7% lightheadedness, 1.3% fluid retention, 0.9% tachycardia, 0.4% headache, 0.3% periorbital edema, and 0.2% insomnia reported in the largest retrospective multicenter study so far of 1404 patients, leading to drug discontinuation in 1.2% of patients.”

The focus on the Pericardial Effusion is significant as it appeared in a woman with a low dose of 1.25mgs/day. So the kew here is to watch for the following symptoms as they appear:

Shortness of breath, discomfort while breathing in the supine position, chest pain, lightheadedness, and swelling in the legs

Any medication can have serious side effects. Aspirin for example, has killed people from allergic reactions, bleeding from long term use, etc.. For those of you who take oral minoxidil, just be alert to the warnings in this article.