MINOXIDIL:

INTRODUCTION:
Minoxidil is a very efficacious active oral vasodilator acting on the arteriolar side of the circulation. Minoxidil is also use in the treatment for male and female baldness.

MECHANISM OF ACTION:
The effect results from the opening of potassium channels in smooth muscles membranes by minoxidil sulphate, the active metabolite. Increased potassium permeability stabilizes the membrane at its resting potential and makes contraction less likely. Like hydralazine, minoxidil dilates arterioles but not veins. Because of greater potential hypertensive effect, minoxidil should replace hydralazine when maximal doses of the later are not effective or in patients with renal failure and severe hypertension, who do not respond well to hydralazine.

PHARMACOKINETICS:
Minoxidil is an antihypertensive with direct vasodilating property. It reduces elevated BP accompanied by reflex tachycardia, increased cardiac output and elevated plasma renin. Applied topically, minoxidil stimulates hair growth secondary to vasodilation, increases cutaneous blood flow and stimulates resting hair follicles.

INDICATIONS:

Androgenic alopecia. Expressed in males as baldness of the vertex of the scalp & in females as diffuse hair loss or thinning of front to parietal areas. Refractory hypertension, usually with a diuretic and -blocker.

CONTRAINDICATIONS:

Pheochromocytoma. Minoxidil solution is contraindicated in those with a history of hypersensitivity to any component of the preparation.

PRECAUTIONS:
Do not use in patients with history of recurrent pericarditis, or history of recurrent or chronic pericardial effusion. Malignant hypertension. Angina. Post MI. Heart failure. Renal dysfunction. Monitor fluid and electrolyte balance, body weight, and for pericardial effusion. Elderly. Labor & delivery. Pregnancy (Cat.C). Nursing mothers: not recommended.

SIDE EFFECTS:
Reflex tachycardia, fluid retention (accompanied by wt gain, oedema, and sometimes deterioration of existing heart failure and changes in the ECG), hypertrichosis. Headache, nausea, gynaecomastia and breast tenderness, polymenorrhoea, skin rash,

MINOXIDIL

By:Zarghoona Uzair

thrombocytopenia. Topical: Systemic effects may also occur; contact dermatitis, pruritus, local burning, flushing; changes in hair colour or texture.

DRUG INTERACTION:
Antihypertensive effect may be enhanced by other hypotensive drugs. Topical: Absorption may be increased with corticosteroids, retinoids, occlusive ointment bases. Avoid guanethidine

DOSAGE: ADULT DOSE: Initially5 mg once daily, may increase at 3 day interval to 10 mg/day.
then 20 mg/day, then 40 mg/day (monitor closely if titrated faster). Usual range 10 40 mg/day; max 100 mg/day. If drop in diastolic pressure >30 mmHg, give in 2 divided doses.

CHILDRENS DOSE: Initially o.2 mg/kg once daily, may increase at 3-day intervals
by 50100%. Usual range 0.251 mg/kg per day; max 50 mg/day.

ONSET: Oral: Approx 30 minutes. Max effect in 2-3 hours. HALF LIFE: 4 hrs DURATION: Oral: 2-5 days. ABSORPTION: 90% absorbed from the GI tract (oral); 0.3-4.5% from intact scalp
(topical).

DISTRIBUTION: Enters breast milk.

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MINOXIDIL

By:Zarghoona Uzair