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minoxidil
generic
Black Box Warnings .
Appropriate Use
administer under close supervision usually in combo with therapeutic doses of beta blocker to prevent tachycardia and incr. myocardial workload; must also usually give with loop diuretic to prevent serious fluid accumulation; hospitalize patients with malignant HTN and if concomitant guanethidine for initial tx, monitor to avoid too rapid or large orthostatic decr. in blood pressure
Serious Cardiac Event Risk
powerful antihypertensive with serious adverse event risk including pericardial effusion sometimes progressing to tamponade and angina pectoris exacerbation; reserve for HTN patients without adequate response to max therapeutic dose of diuretic and 2 other antihypertensives; in animal studies several myocardial lesions and other cardiac adverse events occurred
Adult Dosing .
Dosage forms: TAB: 2.5 mg, 10 mg
HTN, refractory
- [5-40 mg/day PO divided qd-bid]
- Start: 5 mg PO qd, may incr. dose q3 days; Max: 100 mg/day
alopecia (off-label)
- [male patients]
- Dose: 1.25-5 mg/day PO divided qd-bid
- [female patients]
- Dose: 0.25-2.5 mg/day PO divided qd-bid
renal dosing
- [see below]
- renal failure: consider decr. usual dose
- HD: consider decr. usual dose, on dialysis days administer after dialysis; no supplement; PD: consider decr. usual dose; no supplement
hepatic dosing
- [not defined]
Peds Dosing .
- Dosage forms: TAB: 2.5 mg, 10 mg
HTN, refractory
- [<12 yo]
- Dose: 0.25-1 mg/kg/day PO divided qd-bid; Start: 0.1-0.2 mg/kg/dose PO qd, may incr. dose by 0.1-0.2 mg/kg/day q3 days; Max: 50 mg/day
- [>12 yo]
- Dose: 10-40 mg/day PO divided qd-bid; Start: 5 mg PO qd, may incr. dose q3 days; Max: 100 mg/day
HTN, acute severe (off-label)
- [1 yo and older]
- Dose: 0.1-0.2 mg/kg/dose PO q8-12h; Max: 10 mg/dose; Info: for patients with non-life-threatening symptoms
renal dosing
- [see below]
- renal failure: consider decr. usual dose
- HD: consider decr. usual dose, on dialysis days administer after dialysis; no supplement; PD: consider decr. usual dose; no supplement
hepatic dosing
- [not defined]