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MINOXIDIL 10MG TABS 60`S

Ksh 17,099

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What is this medicine and what is it used for?

Oral minoxidil is a potent direct arteriolar vasodilator that opens ATP-sensitive potassium channels in vascular smooth muscle cells, causing hyperpolarisation and relaxation of arterioles, resulting in a marked reduction in systemic vascular resistance and blood pressure.

Oral minoxidil tablets are used for: severe or resistant hypertension — specifically, hypertension that has not been adequately controlled with maximum tolerated doses of three other antihypertensives (including a diuretic). Due to its potency and side effect profile, it is a specialist third or fourth-line agent.

Note: Minoxidil 2% and 5% topical solutions/foams are used separately for androgenetic alopecia (hair loss) — this sheet covers the oral tablet formulation used for hypertension.

How to take this medicine

Starting dose: 5 mg once daily. Titrate upward every 3 days as needed: 10 mg, 20 mg, then 40 mg daily in 1–2 divided doses. Maximum: 100 mg/day. Take with or without food. Always used alongside a loop diuretic (e.g. furosemide) and a beta-blocker to manage the compensatory fluid retention and reflex tachycardia that minoxidil causes.

MUST BE USED WITH A BETA-BLOCKER AND DIURETIC:

Minoxidil causes reflex tachycardia (markedly elevated heart rate) and fluid retention — both of which are dangerous if untreated.

BETA-BLOCKER is essential to block reflex tachycardia and prevent pericardial effusion/cardiac complications.

LOOP DIURETIC (furosemide) is essential to prevent sodium and water retention causing heart failure and oedema.

Minoxidil must NOT be started as monotherapy — it should only be used as a component of combination antihypertensive therapy.

Possible side effects

Frequency

Side Effect

What to Do

Very Common (>10%)

Hypertrichosis (increased body hair growth)

Very common and often distressing — affects arms, legs, face, back. Usually begins 3–6 weeks after starting.

Very Common (>10%)

Fluid retention / peripheral oedema

Diuretic (furosemide) is co-prescribed to manage this.

Very Common (>10%)

Reflex tachycardia

Beta-blocker is co-prescribed to control heart rate.

Common (1–10%)

Pericardial effusion

A serious complication; requires ECG and echocardiogram monitoring.

Common (1–10%)

Weight gain (fluid)

Monitor weight daily — report sudden weight gain > 2 kg in 24 hours.

Common (1–10%)

Hypotension (excessive BP drop)

Monitor BP closely especially at initiation.

Uncommon

Pulmonary hypertension (long-term)

Monitor for increasing breathlessness.

Seek help urgently

Chest pain, increasing breathlessness, rapid weight gain (possible pericardial effusion or heart failure)

Emergency cardiac review.

Contraindications

Minoxidil tablets are contraindicated in: phaeochromocytoma; pulmonary hypertension associated with mitral stenosis; acute MI or recent MI; and known hypersensitivity. Use with extreme caution in renal impairment (can worsen); hepatic impairment; known cardiac disease; and pregnant/breastfeeding women.

Drug interactions

       Guanethidine: additive severe hypotension — avoid concomitant use.

       Other antihypertensives: additive BP lowering — monitor carefully.

       NSAIDs: reduce the antihypertensive effect of minoxidil — avoid.

Storage

Store below 25°C. Original packaging. Keep out of reach of children.

Prescription requirement

PRESCRIPTION ONLY MEDICINE (POM) — Specialist hypertension/cardiology or nephrology prescription.

Monitoring: daily weight, BP, heart rate; ECG; echocardiogram at baseline and during treatment; renal function; electrolytes (potassium important with furosemide co-prescription).

Guidance for patients & caregivers

Oral minoxidil is a very powerful blood pressure medicine for people whose hypertension is difficult to control with standard medicines. It must always be taken alongside a beta-blocker and a diuretic — do not stop any of these without your doctor's advice.

Increased body hair (hypertrichosis) affects almost all patients — on the face, arms, and legs. This is a well-known and common side effect. While it can be distressing, it is not dangerous. It usually reduces or resolves within a few months of stopping treatment.

Weigh yourself every morning before eating. If your weight increases by more than 2 kg in a day, contact your doctor immediately — this may indicate dangerous fluid retention.

Pharmacist & prescriber notes

Oral minoxidil is a third or fourth-line antihypertensive — it is indicated specifically for resistant hypertension after failure of combination therapy including a diuretic, beta-blocker, ACE inhibitor/ARB, and/or calcium channel blocker.

Never initiate without concurrent beta-blocker (e.g. atenolol 100 mg/day) and loop diuretic (furosemide 40–80 mg/day). Pericardial effusion risk: reported in up to 3% of patients with renal failure or inadequately managed fluid retention — baseline echo and 6-monthly echo in high-risk patients.

The 60-tablet pack at 5 mg/day = 60 days; at 10 mg/day = 30 days; at 20 mg/day = 15 days. Minoxidil is increasingly being studied and used at LOW DOSES (0.25–2.5 mg/day) for androgenetic alopecia — this is off-label use and different from the hypertension indication for which this sheet is written.

10  Frequently asked questions

I weigh more today than yesterday — what should I do?

If you gain more than 2 kg in a single day, contact your doctor immediately. This is a sign of significant fluid retention, which means your diuretic dose may need increasing. Fluid retention can lead to breathing difficulty if not managed.

Is this the same minoxidil used for baldness?

Minoxidil was first discovered as an oral blood pressure medicine. Its topical formulations (scalp drops/foam at 2–5%) are used for hair loss. The oral tablets used for hypertension are at much higher doses. Low-dose oral minoxidil is increasingly being explored for hair loss off-label, but this is separate from the hypertension indication.

How often should I check my blood pressure at home?

During dose titration, daily blood pressure monitoring (morning and evening) is strongly recommended. Once stabilised on a dose, check at least several times a week and keep a log. Bring readings to every appointment.

Can I take ibuprofen for pain while on minoxidil?

Avoid regular NSAIDs — they reduce minoxidil's effectiveness and can worsen kidney function. Paracetamol is the recommended pain reliever.

How long will I need to take oral minoxidil?

Resistant hypertension typically requires long-term treatment. Your cardiologist will review regularly and may be able to consider alternative approaches as new treatments become available.


 

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