Oral Minoxidil – When I Use It

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Traditionally that we are familiar with oral finasteride also known as Propecia for male pattern hair loss and also for women after menopause, as well as topical. In other words, putting it on top of your hair on the skin for minoxidil, for two and five percent for women and men. Although it has been clear since 2014 for use of 5% once a day for women as well. So, the traditional formula has always been oral finasteride, topical minoxidil. And in the last few years, I have switched over now to using more topical finasteride because people just don’t want the side effect profile of oral Propecia. And topical finasteride is a way to further minimize that issue. It was interesting is that I have been now using oral minoxidil instead of topical minoxidil in a select group of patients with very good results. So, all minoxidil is a prescription product and some patients that really need the topical minoxidil or allergic to it and they get an allergic response and even though switching over from the liquid over to the phone version has removed what’s called propylene glycol, which is an irritant. They still have an allergic response to the topical formulation and so they have no other means of taking the topical whether they do it may be less frequently, but they still have a reaction to it. So, in these patients, I really like oral minoxidil. I usually dose about two point five milligrams. The biggest issue with or minoxidil is if you’ve got low blood pressure, it could theoretically drop the blood pressure. It is an anti-hypertensive. In other words, it’s used to treat high blood pressure. It is something that if you’re having high blood pressure to could be a good thing, but it’s usually so small, the dose that it doesn’t affect the blood pressure. And I always encourage if there’s any questions to see your questions with your family doctor, who really manages everything. And there can be some issues with lower leg swelling in rare cases as well. So, we can always decrease the dose down to one milligram if needed and we can even increase it to 5 milligrams. But generally speaking out for most patients I’m at the 2.5 milligram dose. So, oral minoxidil may be a good alternative for those who are that fit sort of the safety profile of what’s out there and who potentially may be allergic to the topical formulation


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