Minoxidil

Tablet · Topical, Oral

Over the counter Arteriolar Vasodilator

Boxed warning. Minoxidil tablets contain the powerful antihypertensive agent, minoxidil, which may produce serious adverse effects. It can cause pericardial effusion, occasionally progressing to tamponade, and angina pectoris may be exacerbated. Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. In experimental animals, minoxidil caused several kinds of myocardial lesions as well as other adverse cardiac effects (see Cardiac Lesions in Animals ). Minoxidil must be administered under close supervision, usually concomitantly with therapeutic doses of a beta-adrenergic blocking agent to prevent tachycardia and increased myocardial workload. It must also usually be given with a diuretic, frequently one acting in the ascending limb of the loop of Henle, to prevent serious fluid accumulation.…

Uses

Because of the potential for serious adverse effects, minoxidil tablets are indicated only in the treatment of hypertension that is symptomatic or associated with target organ damage and is not manageable with maximum therapeutic doses of a diuretic plus two other antihypertensive drugs. At the present time use in milder degrees of hypertension is not recommended because the benefit-risk relationship in such patients has not been defined. Minoxidil reduced supine diastolic blood pressure by 20 mmHg or to 90 mmHg or less in approximately 75% of patients, most of who had hypertension that could not be controlled by other drugs.

Warnings

1. Salt and Water Retention: Congestive Heart Failure - concomitant use of an adequate diuretic is required - Minoxidil tablets must usually be administered concomitantly with a diuretic adequate to prevent fluid retention and possible congestive heart failure; a high ceiling (loop) diuretic is almost always required. Body weight should be monitored closely. If minoxidil is used without a diuretic, retention of several hundred milli-equivalents of salt and corresponding volumes of water can occur within a few days, leading to increased plasma and interstitial fluid volume and local or generalized edema. Diuretic treatment alone, or in combination with restricted salt intake, will usually minimize fluid retention, although reversible edema did develop in approximately 10% of nondialysis patients so treated. Ascites has also been reported. Diuretic effectiveness was limited mostly by disease-related impaired renal function. The condition of patients with pre-existing congestive heart failure occasionally deteriorated in association with fluid retention although because of the fall in blood pressure (reduction of afterload), more than twice as many improved than worsened. Rarely, refractory fluid retention may require discontinuation of minoxidil. Provided that the patient is under close medical supervision, it may be possible to resolve refractory salt retention by discontinuing minoxidil for 1 or 2 days and then resuming treatment in conjunction with vigorous diuretic therapy. 2. Concomitant Treatment to Prevent Tachycardia is Usually Required - Minoxidil increases the heart rate. Angina may worsen or appear for the first time during minoxidil treatment, probably because of the increased oxygen demands associated with increased heart rate and cardiac output. The increase in rate and the occurrence of angina generally can be prevented by the concomitant administration of a beta-adrenergic blocking drug or other sympathetic nervous system suppressant. The ability of beta-adrenergic blocking agents to minimize papillary muscle lesions in animals is further reason to utilize such an agent concomitantly. Round-the-clock effectiveness of the sympathetic suppressant should be ensured. 3. Pericarditis, Pericardial Effusion and Tamponade - There have been reports of pericarditis occurring in association with the use of minoxidil. The relationship of this association to renal status is uncertain. Pericardial effusion, occasionally with tamponade, has been observed in about 3% of treated patients not on dialysis, especially those with inadequate or compromised renal function. Although in many cases, the pericardial effusion was associated with a connective tissue disease, the uremic syndrome, congestive heart failure, or marked fluid retention, there have been instances in which these potential causes of effusion were not present. Patients should be observed closely for any suggestion of a pericardial disorder, and echocardiographic studies should be carried out if suspicion arises. More vigorous diuretic therapy, dialysis, pericardiocentesis, or surgery may be required. If the effusion persists, withdrawal of minoxidil should be considered in light of other means of controlling the hypertension and the patient’s clinical status. 4. Interaction with Guanethidine: Although minoxidil does not itself cause orthostatic hypotension, its administration to patients already receiving guanethidine can result in profound orthostatic effects. If at all possible, guanethidine should be discontinued well before minoxidil is begun. Where this is not possible, minoxidil therapy should be started in the hospital and the patient should remain institutionalized until severe orthostatic effects are no longer present or the patient has learned to avoid activities that provoke them. 5. Hazard of Rapid Control of Blood Pressure: In patients with very severe blood pressure elevation, too rapid control of blood pressure, especially with intravenous agents, can precipitate syncope, cerebrovascular accidents, myocardial infarction and ischemia of special sense organs with resulting decrease or loss of vision or hearing. Patients with compromised circulation or cryoglobulinemia may also suffer ischemic episodes of the affected organs. Although such events have not been unequivocally associated with minoxidil use, total experience is limited at present. Any patient with malignant hypertension should have initial treatment with minoxidil carried out in a hospital setting, both to assure that blood pressure is falling and to assure that it is not falling more rapidly than intended.

Dosage and administration

Patients over 12 years of age: The recommended initial dosage of minoxidil tablets is 5 mg given as a single daily dose. Daily dosage can be increased to 10 mg, 20 mg and then to 40 mg in single or divided doses if required for optimum blood pressure control. The effective dosage range is usually 10 to 40 mg per day. The maximum recommended dosage is 100 mg per day. Patients under 12 years of age: The initial dosage is 0.2 mg/kg minoxidil as a single daily dose. The dosage may be increased in 50 to 100% increments until optimum blood pressure control is achieved. The effective dosage range is usually 0.25 to 1.0 mg/kg/day. The maximum recommended dosage is 50 mg daily ( see 9 . Pediatric Use under PRECAUTIONS ). Dose frequency: The magnitude of within-day fluctuation of arterial pressure during therapy with minoxidil is directly proportional to the extent of pressure reduction. If supine diastolic pressure has been reduced less than 30 mmHg, the drug need be administered only once a day; if supine diastolic pressure has been reduced more than 30 mmHg, the daily dosage should be divided into two equal parts. Frequency of dosage adjustment: Dosage must be titrated carefully according to individual response. Intervals between dosage adjustments normally should be at least 3 days since the full response to a given dose is not obtained for at least that amount of time. Where a more rapid management of hypertension is required, dose adjustments can be made every 6 hours if the patient is carefully monitored. Concomitant therapy: Diuretic and beta-blocker or other sympathetic nervous system suppressant. Diuretics : Minoxidil must be used in conjunction with a diuretic in patients relying on renal function for maintaining salt and water balance. Diuretics have been used at the following dosages when starting therapy with minoxidil: hydrochlorothiazide (50 mg, b.i.d.) or other thiazides at equi-effective dosage; chlorthalidone (50 mg to 100 mg, once daily); furosemide (40 mg, b.i.d.). If excessive salt and water retention results in a weight gain of more than 5 pounds, diuretic therapy should be changed to furosemide; if the patient is already taking furosemide, dosage should be increased in accordance with the patient’s requirements. Beta-blocker or other sympathetic nervous system suppressants: When therapy with minoxidil is begun, the dosage of a beta-adrenergic receptor blocking drug should be the equivalent of 80 mg to 160 mg of propranolol per day in divided doses. If beta-blockers are contraindicated, methyldopa (250 mg to 750 mg, b.i.d.) may be used instead. Methyldopa must be given for at least 24 hours before starting therapy with minoxidil because of the delay in the onset of methyldopa’s action. Limited clinical experience indicates that clonidine may also be used to prevent tachycardia induced by minoxidil; the usual dosage is 0.1 to 0.2 mg twice daily. Sympathetic nervous system suppressants may not completely prevent an increase in heart rate due to minoxidil but usually do prevent tachycardia. Typically, patients receiving a beta-blocker prior to initiation of therapy with minoxidil have a bradycardia and can be expected to have an increase in heart rate toward normal when minoxidil is added. When treatment with minoxidil and beta-blocker or other sympathetic nervous system suppressant are begun simultaneously, their opposing cardiac effects usually nullify each other, leading to little change in heart rate.

Label text from the FDA structured product label by Par Health USA, LLC (revised Jun 11, 2026). Long sections are shortened; the complete label is on DailyMed.

Active ingredients

Minoxidil NDC products (67)

NDCStrength & formLabelerType
50090-7760Minoxidil 10 mg/1
Tablet
A-S Medication SolutionsANDA
50090-7758Minoxidil 2.5 mg/1
Tablet
A-S Medication SolutionsANDA
0591-5642Minoxidil 2.5 mg/1
Tablet
Actavis Pharma, Inc.ANDA
0591-5643Minoxidil 10 mg/1
Tablet
Actavis Pharma, Inc.ANDA
68084-205Minoxidil 10 mg/1
Tablet
American Health PackagingANDA
68084-204Minoxidil 2.5 mg/1
Tablet
American Health PackagingANDA
43353-342Minoxidil 2.5 mg/1
Tablet
Aphena Pharma Solutions - Tennessee, LLCANDA
42291-618Minoxidil 2.5 mg/1
Tablet
AvKAREANDA
63629-2231Minoxidil 10 mg/1
Tablet
Bryant Ranch PrepackANDA
63629-9620Minoxidil 10 mg/1
Tablet
Bryant Ranch PrepackANDA
63629-9433Minoxidil 2.5 mg/1
Tablet
Bryant Ranch PrepackANDA
63629-9299Minoxidil 10 mg/1
Tablet
Bryant Ranch PrepackANDA
63629-2232Minoxidil 2.5 mg/1
Tablet
Bryant Ranch PrepackANDA
63629-2230Minoxidil 10 mg/1
Tablet
Bryant Ranch PrepackANDA
71335-3120Minoxidil 10 mg/1
Tablet
Bryant Ranch PrepackANDA
71335-3174Minoxidil 2.5 mg/1
Tablet
Bryant Ranch PrepackANDA
72162-1489Minoxidil 2.5 mg/1
Tablet
Bryant Ranch PrepackANDA
72162-1490Minoxidil 10 mg/1
Tablet
Bryant Ranch PrepackANDA
63629-1086Minoxidil 10 mg/1
Tablet
Bryant Ranch PrepackANDA
84382-001Minoxidil 50 mg/g
Aerosol, Foam
Clarity Cosmetics Inc.ANDA
51316-213Minoxidil 50 mg/g
Aerosol, Foam
CVS PharmacyANDA
51316-212Minoxidil 50 mg/g
Aerosol, Foam
CVS PharmacyANDA
51407-902Minoxidil 10 mg/1
Tablet
Golden State Medical Supply, Inc.ANDA
51407-901Minoxidil 2.5 mg/1
Tablet
Golden State Medical Supply, Inc.ANDA
37808-833Minoxidil 5 g/100mL
Solution
H E BANDA
70550-116Minoxidil 50 mg/g
Aerosol, Foam
KeraniqueANDA
59450-210Minoxidil 50 mg/g
Aerosol, Foam
Kroger CompanyANDA
59450-211Minoxidil 50 mg/g
Aerosol, Foam
Kroger CompanyANDA
0113-5129Minoxidil 50 mg/g
Aerosol, Foam
L. Perrigo CompanyANDA
68071-3794Minoxidil 2.5 mg/1
Tablet
NuCare Pharmaceuticals, Inc.ANDA
68071-5324Minoxidil 2.5 mg/1
Tablet
NuCare Pharmaceuticals, Inc.ANDA
59726-151Minoxidil 50 mg/g
Aerosol, Foam
P & L Development, LLCANDA
59726-122Minoxidil 50 mg/g
Aerosol, Foam
P & L Development, LLCANDA
59726-116Minoxidil 50 mg/g
Aerosol, Foam
P & L Development, LLCANDA
59726-115Minoxidil 50 mg/g
Aerosol, Foam
P & L Development, LLCANDA
59726-125Minoxidil 50 mg/mL
Aerosol, Foam
P & L Development, LLCANDA
49884-256Minoxidil 2.5 mg/1
Tablet
Par Health USA, LLCANDA
49884-257Minoxidil 10 mg/1
Tablet
Par Health USA, LLCANDA
72789-279Minoxidil 10 mg/1
Tablet
PD-Rx Pharmaceuticals, Inc.ANDA
72789-278Minoxidil 2.5 mg/1
Tablet
PD-Rx Pharmaceuticals, Inc.ANDA
68788-8273Minoxidil 2.5 mg/1
Tablet
Preferred Pharmaceuticals Inc.ANDA
70550-605Minoxidil 50 mg/g
Aerosol, Foam
PROFECTUS BEAUTY LLCANDA
82804-240Minoxidil 2.5 mg/1
Tablet
Proficient Rx LPANDA
71205-757Minoxidil 2.5 mg/1
Tablet
Proficient Rx LPANDA
56062-070Minoxidil 2 g/100mL
Solution
Publix Super Markets IncANDA
56062-322Minoxidil 5 g/100mL
Solution
Publix Super Markets IncANDA
82796-100Minoxidil 50 mg/g
Aerosol, Foam
RESTORATION HOLDINGS, LLCANDA
72484-095Minoxidil 5 g/100mL
Solution
Roman Health Ventures Inc.ANDA
72484-097Minoxidil 5 g/100mL
Spray
Roman Health Ventures Inc.ANDA
69113-128Minoxidil 50 mg/g
Aerosol, Foam
SCIENTIFIC HAIR RESEARCH, LLCANDA
69113-129Minoxidil 50 mg/g
Aerosol, Foam
SCIENTIFIC HAIR RESEARCH, LLCANDA
82376-6007Minoxidil 50 mg/g
Aerosol, Foam
SPAZI INC.ANDA
82376-6006Minoxidil 50 mg/g
Aerosol, Foam
SPAZI INC.ANDA
53489-387Minoxidil 10 mg/1
Tablet
Sun Pharmaceutical Industries, Inc.ANDA
53489-386Minoxidil 2.5 mg/1
Tablet
Sun Pharmaceutical Industries, Inc.ANDA
51672-2128Minoxidil 50 mg/g
Aerosol, Foam
Sun Pharmaceutical Industries, Inc.ANDA
51672-2129Minoxidil 50 mg/g
Aerosol, Foam
Sun Pharmaceutical Industries, Inc.ANDA
11673-157Minoxidil 50 mg/g
Aerosol, Foam
TARGET CorporationANDA
11673-158Minoxidil 50 mg/g
Aerosol, Foam
TARGET CorporationANDA
71713-094Minoxidil 5 g/100mL
Solution
THIRTY MADISON INCANDA
71713-091Minoxidil 50 mg/g
Aerosol, Foam
Thirty MADISON, Inc.ANDA
80855-201Minoxidil 50 mg/g
Aerosol, Foam
Virtue Labs, LLCANDA
0363-9091Minoxidil 50 mg/g
Aerosol, Foam
Walgreen CompanyANDA
0363-9090Minoxidil 50 mg/g
Aerosol, Foam
Walgreen CompanyANDA
0363-9970Minoxidil 2 g/100mL
Solution
WalgreensANDA
0363-9971Minoxidil 50 mg/mL
Solution
WalgreensANDA
0363-9973Minoxidil 50 mg/mL
Solution
WalgreensANDA

Frequently asked questions

What is Minoxidil used for?

Because of the potential for serious adverse effects, minoxidil tablets are indicated only in the treatment of hypertension that is symptomatic or associated with target organ damage and is not manageable with maximum therapeutic doses of a diuretic plus two other antihypertensive drugs. At the present time use in milder degrees of hypertension is not recommended because the benefit-risk…

Who makes Minoxidil?

Minoxidil is listed by 32 labelers in the FDA NDC directory, including A-S Medication Solutions, Actavis Pharma, Inc., American Health Packaging, Aphena Pharma Solutions - Tennessee, LLC.