In the U.S.—

In Canada—

• Hair growth stimulant, alopecia androgenetica, topical

Minoxidil (mi-NOX-i-dil) applied to the scalp is used to stimulate hair growth in adult men and women with a certain type of baldness. The exact way that this medicine works is not known.

If hair growth is going to occur with the use of minoxidil, it usually occurs after the medicine has been used for several months and lasts only as long as the medicine continues to be used. Hair loss will begin again within a few months after minoxidil treatment is stopped.

In the U.S., this medicine is available without a prescription. In Canada, this medicine is available only with your doctor's prescription. It is available in the following dosage form:

Topical
• Topical solution (U.S. and Canada)

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For topical minoxidil, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to minoxidil or propylene glycol (nonactive product in medicine). Also tell your health care professional if you are allergic to any other substances, such as preservatives or dyes.

Pregnancy—Topical minoxidil has not been studied in pregnant women. However, some studies in animals have shown that minoxidil, when given by mouth, causes problems during pregnancy, although the studies have not shown that the medicine causes birth defects. Before using this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant.

Breast-feeding—It is not known whether topical minoxidil passes into breast milk. However, minoxidil, taken by mouth, does pass into breast milk. Minoxidil is not recommended during breast-feeding, because it may cause problems in nursing babies.

Children—Studies of this medicine have been done only in adult patients, and there is no specific information comparing use of topical minoxidil in children up to 18 years of age with use in other age groups. Use in infants and children is not recommended. If you think your child has hair loss, discuss it with the doctor.

Older adults—This medicine has been tested in a limited number of older patients up to 65 years of age and has not been shown to cause different side effects or problems in this age group than it does in younger adults. However, studies have shown that the medicine works best in younger patients who have a short history of hair loss. Minoxidil has not been studied in patients older than 65 years of age.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using topical minoxidil, it is especially important that your health care professional know if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine or if you are using any of the following on your scalp:

• Corticosteroids (cortisone-like medicines) or
• Petrolatum (e.g., Vaseline) or
• Tretinoin (e.g., Retin-A)—Use of these products on your scalp may cause too much topical minoxidil to be absorbed into the body and may increase the chance of side effects

• Any other skin problems or an irritation or a sunburn on the scalp—The condition may cause too much topical minoxidil to be absorbed into the body and may increase the chance of side effects

• Heart disease or
• Hypertension (high blood pressure)—Topical minoxidil has not been studied in patients who have these conditions, but more serious problems may develop for these patients if they use more medicine than is recommended over a large area and too much minoxidil is absorbed into the body

This medicine usually comes with patient instructions. It is important that you read the instructions carefully.

It is very important that you use this medicine only as directed. Do not use more of it and do not use it more often than your doctor ordered. To do so may increase the chance of it being absorbed through the skin. For the same reason, do not apply minoxidil to other parts of your body. Absorption into the body may affect the heart and blood vessels and cause unwanted effects.

Do not use any other skin products on the same skin area on which you use minoxidil. Hair coloring, hair permanents, and hair relaxers may be used during minoxidil therapy as long as the scalp is washed just before applying the hair coloring, permanent, or relaxer. Minoxidil should not be used 24 hours before and after the hair treatment procedure. Be sure to not double your doses of minoxidil to make up for any missed doses.

To apply minoxidil solution:

• Make sure your hair and scalp are completely dry before applying this medicine.
• Apply the amount prescribed to the area of the scalp being treated, beginning in the center of the area. Follow your doctor's instructions on how to apply the solution, using the applicator provided.
• Do not shampoo your hair for 4 hours after applying minoxidil.
• Immediately after using this medicine, wash your hands to remove any medicine that may be on them.
• Do not use a hairdryer to dry the scalp after you apply minoxidil solution. Blowing with a hairdryer on the scalp may make the treatment less effective.
• Allow the minoxidil to completely dry for 2 to 4 hours after applying it, including before going to bed. Minoxidil can stain clothing, hats, or bed linen if your hair or scalp is not fully dry after using the medicine.
• Avoid transferring the medicine while wet to other parts of the body. This can occur if the medicine gets on your pillowcase or bed linens or if your hands are not washed after applying minoxidil.

If your scalp becomes abraded, irritated, or sunburned, check with your doctor before applying minoxidil.

Keep this medicine away from the eyes, nose, and mouth . If you should accidentally get some in your eyes, nose, or mouth, flush the area thoroughly with cool tap water. If you are using the pump spray, be careful not to breathe in the spray.

Dosing—

The dose of topical minoxidil will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average dose of topical minoxidil. If your dose is different, do not change it unless your doctor tells you to do so.

• For topical solution dosage form:
  • For hair growth:
    • Adults up to 65 years of age—Apply 1 milliliter to the scalp two times a day.
    • Adults 65 years of age and older—Use and dose must be determined by the doctor.
    • Infants—Use is not recommended.
    • Children up to 18 years of age—Use and dose must be determined by the doctor.

Missed dose—

If you miss a dose of this medicine, go back to your regular dosing schedule. Do not double doses.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Keep the medicine from freezing.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.
• Flammable: Keep away from fire or flame.

It is important that your doctor check your progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

Tell your doctor if you notice continued itching, redness, or burning of your scalp after you apply minoxidil. If the itching, redness, or burning is severe, wash the medicine off and check with your doctor before using it again.

Hair loss may continue for 2 weeks after you start using minoxidil. Tell your doctor if your hair loss continues after 2 weeks. Also, tell your doctor if your hair growth does not increase after using minoxidil for 4 months.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• Less common
  • Itching or skin rash (continued) 
  
  

• Rare
  • Acne at site of application;  burning of scalp;  increased hair loss;  inflammation or soreness at root of hair;  reddened skin;  swelling of face 
  
  

• Signs and symptoms of too much medicine being absorbed into the body—Rare
  • Blurred vision or other changes in vision;  chest pain;  decrease of sexual ability or desire ;  fast or irregular heartbeat;  flushing;  headache;  lightheadedness ;  numbness or tingling of hands, feet, or face;  swelling of face, hands, feet, or lower legs;  weight gain (rapid) 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.