Minoxidil (minoxidil)
Also sold as: Mintop, Tugain, Morr-F, Regaine, Hair4U
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
topical solution 2% (60 mL) +5
Indications
- Androgenetic alopecia — male pattern hair loss (topical 5%)
- Androgenetic alopecia — female pattern hair loss (topical 2–5%)
- Alopecia areata (off-label)
- Resistant / refractory hypertension (oral — third-line add-on)
Adult Dosing
Male androgenetic alopecia (topical)
5% solution or foam — apply 1 mL (solution) or half a capful (foam) to dry scalp
Twice daily (BD); ongoing — stop using and hair loss resumes within 3–6 months
Apply to dry scalp, not to wet hair. Allow to dry for 2–4 hours before lying down. Minimum 4–6 months before assessing response.
Female androgenetic alopecia (topical)
2% solution — apply 1 mL to dry scalp twice daily; 5% may be used (off-label for women)
Twice daily; ongoing
Women should use 2% as first choice; 5% may cause more facial hypertrichosis.
Alopecia (oral, off-label)
0.625–2.5 mg once daily
Ongoing; lowest effective dose
Low-dose oral minoxidil (LDOM) gaining evidence for androgenetic alopecia and alopecia areata; monitor for fluid retention and cardiovascular effects.
Resistant hypertension (oral)
5 mg once daily initially; titrate to 5–40 mg/day
Once or twice daily; long-term
Always combined with a loop diuretic (to prevent fluid retention) and a beta-blocker (to prevent reflex tachycardia). Third-line agent.
Pregnancy & Lactation
Pregnancy: Category C
Topical: systemic absorption is low (~1–2%); avoid extensive use especially in first trimester. Oral: avoid during pregnancy due to systemic effects and risk of fetal hypertrichosis. Use only if benefit clearly outweighs risk.
Lactation: Caution
Oral minoxidil is excreted in breast milk — avoid. Topical: minimal absorption, but apply away from breast area and avoid if breastfeeding.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Antihypertensive drugs (beta-blockers, ACE inhibitors, diuretics, calcium channel blockers) | Additive hypotension with oral minoxidil — monitor blood pressure; dose adjustments may be needed | Moderate |
| Guanethidine | Severe orthostatic hypotension with oral minoxidil — combination should be avoided; if used, hospitalise initially | Major |
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Side Effects
Common
- Topical: scalp irritation, itching, dryness
- Topical: hypertrichosis at application site (unwanted hair growth)
- Topical: contact dermatitis (more common with propylene glycol in solution formulation)
- Topical: initial shedding in first 2–4 weeks (telogen effluvium — temporary, hair regrows)
- Oral: fluid retention and oedema
- Oral: tachycardia and palpitations
- Oral: generalized hypertrichosis (facial hair in women)
Serious / Discontinue If
- Oral: pericardial effusion (rare but serious — can occur with high doses or renal impairment)
- Oral: pulmonary hypertension (rare)
- Oral: severe fluid overload / heart failure (especially without concurrent diuretic)
- Oral: hypotension / syncope
- Topical (absorbed systemic): cardiovascular effects if large amounts applied (rare)
Contraindications
- Hypersensitivity to minoxidil
- Phaeochromocytoma (oral) — may stimulate catecholamine release
- Pregnancy (oral)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Mintop 5% solution 60mL | Dr Reddy's Laboratories | ₹285/60mL |
| Tugain 5% solution 60mL | Cipla | ₹265/60mL |
| Morr-F 5% + finasteride 0.1% solution 60mL | Sun Pharma | ₹325/60mL |
Monitoring Required
- Blood pressure and heart rate (especially with oral minoxidil)
- Weight monitoring for fluid retention (oral)
- Echocardiogram if pericardial effusion suspected (oral, high doses)
- Renal function (oral)
- Hair growth response — photographic assessment at 3, 6, 12 months
Patient Counseling Points
- Apply the solution to a dry scalp (not wet hair) — use the nozzle to apply directly to scalp
- Allow to dry fully before sleeping or wearing a hat — takes 2–4 hours
- Initial hair shedding in weeks 1–4 is normal — old resting hairs are pushed out; new growth follows
- Results take 4–6 months to see clearly — do not stop early
- Stopping minoxidil will result in reversal of any gains within 3–6 months
- Women should use 2% formulation — 5% may cause unwanted facial hair growth
- Avoid contact with eyes, mouth, and broken skin
- Wash hands thoroughly after applying
- For oral minoxidil: report any unusual weight gain, leg swelling, or rapid heartbeat to your doctor immediately
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Clinically reviewed by: Dr. Rajan Chopra, MD (Dermatology), Fellowship Trichology (IAT), Consultant Trichologist
Last reviewed: 2026-04-01
References
- Mintop SmPC — Dr Reddy's Laboratories India
- Suchonwanit P et al. Minoxidil and its use in hair disorders. Drug Des Devel Ther. 2019
- Randolph M, Tosti A. Oral minoxidil for hair loss. J Am Acad Dermatol. 2021
- BAD Guidelines on Androgenetic Alopecia 2021