What is Minoxidil?

Minoxidil is an organic, white or off-white crystalline powder. Clinically, as a potassium channel opener, it can directly relax vascular smooth muscle, has a strong effect of dilating small arteries, reduces peripheral resistance and blood pressure, and has no effect on volume vessels, so it can promote venous return. At the same time, due to the effect of reflex regulation and positive frequency, it can increase cardiac output and heart rate, but does not cause orthostatic hypotension.

• What is the mechanism of action of Minoxidil?

• What are the precautions for the use of Minoxidil?

• How is Minoxidil used?

What is the mechanism of action of Minoxidil?

Minoxidil has a similar effect to hydralazine, but has a stronger and longer-lasting effect. It directly acts on vascular smooth muscle, dilates small arteries, reduces peripheral resistance, thus lowers blood pressure, and has no significant effect on volume vessels. It can also reflexively excite the sympathetic nerves to increase heart rate, increase cardiac output, increase plasma renin activity, and retain water and sodium during hypotension. The increased heart rate is also related to the direct positive inotropic effect of this product on the heart. Its water and sodium retention effect is partly due to increased renin secretion and partly due to increased renal tubular reabsorption of Na+ and water due to direct action on the renal tubules. Water and sodium retention and increased cardiac output can reduce the antihypertensive effect of this product, so it is often not used alone but in combination with diuretics and beta-blockers in patients with severe hypertension. Its mechanism of action may be due to the metabolism of Minoxidil NO sulfate in vivo, which increases the permeability of vascular smooth muscle cell membrane to K+, promotes the efflux of intracellular K+, causes hyperpolarization of vascular smooth muscle cell membrane, and thus relaxes vascular smooth muscle and induces hyperpolarization of vascular smooth muscle. Blood pressure drops.

What are the precautions for the use of Minoxidil?

1. Blood urea nitrogen and creatinine increased initially after treatment with Minoxidil, but decreased to pre-drug levels after continued treatment.

2. Plasma renin activity, serum alkaline phosphatase, and serum sodium may be increased.

3. Blood counts and hemoglobin may decrease due to hemodilution.

4. Blood pressure and body weight should be measured regularly when using Minoxidil.

5. Abrupt withdrawal can cause rebound in blood pressure, so it is advisable to withdraw the drug gradually.

Pregnant and lactating women medication:

Minoxidil can cross the placenta, but human studies are not enough, and it has lethal effects in rats and rabbits. Therefore, pregnant women should use it with caution. Can be excreted into breast milk, but there are no reports of effects on infants. No data have been reported for breastfeeding women.

Medication for the elderly:

The elderly are sensitive to the antihypertensive effect, and the renal function is often poor, so the dose of Minoxidil should be reduced accordingly.

How is Minoxidil used?

1. The usual dose of Minoxidil for adults: Oral, start with 2.5 mg/time, twice a day, then double the dose every 3 days, and gradually increase until the curative effect occurs. The maintenance dose is 10-40 mg per day, taken in single or divided doses. No more than 100 mg per day.

2. The usual dose of Minoxidil in children: oral administration of 0.2 mg/kg per day according to body weight, once a day. After that, the dose should be adjusted every 3 days, and the body weight should be increased by 0.1 mg/kg every day, up to 50 mg a day under the age of 12. The maintenance dose is 0.25 to 1 mg/kg of body weight per day, taken once or in divided doses.

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