Originally developed to treat high blood pressure, Minoxidil is now widely prescribed off-label for hair loss. It boosts blood flow to hair follicles and helps regrow hair on the crown and mid-scalp. The brand we use is called Loniten. ​ This 2.5mg version is popular because it delivers strong results with fewer side effects than higher doses. Most new starters take one tablet daily and start to see results within a few months.

No messy foams or liquids — just one tablet a day Often works when topical Minoxidil fails or causes irritation Can be used with Finasteride or topical Minoxidil for stronger results Made by licensed UK or EU manufacturers Fewer skin reactions and more consistent absorption

Take 1 tablet daily, ideally at the same time each day You can take it with or without food Do not exceed the recommended dose ​ A common starting dose is 0.625mg per day for women and 1.25mg per day for men. You should get a tablet cutter from your pharmacy and cut a 2.5mg tablet into quarters or halves to get this dose. ​ The optimum dose for hair loss is not entirely clear. It may be in the region of 0.625mg to 2.5 mg daily. For men, a slightly higher dose may sometimes be required. You may be asked to take the medication daily or every other day. ​ Doses of minoxidil for hair loss are considered ‘low dose’. This is because the doses used for hair loss are a lot lower than the doses which are used for conditions such as hypertension. The doses used for hypertension are 10-40mg per day.

You may notice less shedding in 8–12 weeks. Visible regrowth usually starts around month 3. However, results vary between individuals. To keep your results, you’ll need to keep taking it long-term.

The studies are very small but indicate that about one-third of patients will notice a reduction in shedding, and a third will notice improved growth in 6 months or more. This means that up to 2 in 3 people may notice benefits from oral Minoxidil. It is best to take treatment for 6 to 12 months to give it enough time to work. ​ The only head-to-head study comparing oral minoxidil to topical minoxidil in women with Female Pattern Hair Loss showed that 1mg of minoxidil gave comparable effects to 5% solution (1ml) once a day (Ramos et al. 2020). In this study, 26 women received oral minoxidil and 26 women received topical minoxidil. After 24 weeks of treatment, there was a 12% increase in hair density for women on oral minoxidil and 7.2% increase for women applying topical minoxidil. The difference was not statistically significant, but the oral minoxidil group also had less hair shedding.

Side effects are uncommon at the low doses used to treat hair loss. The largest study looking at side effects (Vañó-Galván et al. 2021) showed that in 943 women and 461 men,  2.5% of women and 0.5% of men had to stop treatment because of a side effect. ​ Excessive hair (Hypertrichosis). The most common side effect is hypertrichosis for both men and women- excess hair growth elsewhere on the face and body. Excess growth is more likely to occur at higher doses. While this side effect is bothersome, it can usually be managed with hair removal methods and is not a common reason for someone to stop. Hypertrichosis may affect 10-25% of those on low doses (<4mg) and up to 50% of those on higher doses (>5mg). Vañó-Galván et al showed that 20% of women and 6% of men experienced hypertrichosis. Of those that experience this side effect, only 5% of women and 0% of men find it necessary to stop treatment. Temporary shedding. Temporary shedding is very common at the onset of starting oral or topical Minoxidil. This side effect occurs within the first 6 weeks and can be of significant concern. However, it is important to continue with the medication as this will stop after 4 weeks. Ankle swelling and fluid retention. Swelling of the lower legs can occur in up to 3% people. This is usually at higher doses. Fluid retention can also sometimes show up around the eyes as puffy eyes, which are worse in the morning. Vañó-Galván et al showed that 1.3% get ankle swelling (25% of these individuals stop treatment), and 0.3% experience swelling around the eyes (0% need to stop treatment for this). Low blood pressure and feeling lightheaded. Minoxidil is also used to control high blood pressure, usually at doses of 10-40mg per day – much higher than the doses used for hair loss. However, even lower doses can sometimes cause a reduction in blood pressure. 2% of people may get postural hypotension with low doses of Minoxidil. 8% may have general symptoms of lightheadedness. This leads to dizziness when getting up quickly. 1.7% of those on low-dose Minoxidil experience lightheadedness, and of these, only 11% need to stop treatment. Fast heart rate. Minoxidil can also cause a fast heart rate, but this is usually at higher doses. You should alert your doctor if you are taking other medications, such as asthma inhalers which can also increase the heart rate. 0.9% of those on low-dose oral minoxidil appear to experience this side effect, and 33% of these individuals need to stop treatment. Headaches. Headaches may occur in as many as 9% of people, but again, this seems to get better with time. 0.4% experience this side effect, and of these 44% need to stop treatment. Worsened hangovers. A 2024 report has suggested that that oral minoxidil may exacerbate alcohol hangover symptoms such as nausea, headaches, and light sensitivity in a small number of people taking oral minoxidil. The mechanism is unknown. The authors recommend that patients consider skipping their oral minoxidil dose on days they anticipate consuming excessive alcohol. There is a need for further research into this potential interaction. Uncommon side effects include – nightmares, insomnia, pericarditis, skin rashes, nausea, vomiting, and breast tenderness. ​ It is important to report side effects to your doctor. However, if there is a rapid increase in pulse rate, palpitations, feeling dizzy, shortness of breath, chest pain and fainting, then you are advised to go to the A&E department or call the emergency services.

There are certain instances when it is not safe to have oral minoxidil. These are listed below, and you should ensure your doctor is aware of any underlying health conditions you may have. ​ Minoxidil should be avoided if you have: drug allergy – NB it appears that oral minoxidil is safe if you have reacted to topical minoxidil even if your patch tests shows you react to minoxidil and not to the preservatives sun propylene glycol (Thearinou et al 2020) pheochromocytoma pulmonary hypertension with mitral stenosis severe hepatic impairment angina or recent myocardial infarction (heart attack) left ventricular hypertrophy heart failure ​ Try to reduce alcohol & caffeine consumption as this can impact your blood pressure and heart rate. ​

While there are a number of medical reports to show that oral Minoxidil helps hair loss, until larger, more statistically sophisticated studies are carried out, oral Minoxidil for hair loss will remain unlicensed in the UK. This means that you can only receive a prescription if the benefits outweigh the risks for using this medication for hair loss. You must also take the time to read the information on unlicensed medications (such as this fact sheet) and agree that you feel the benefits outweigh the risks. ​ Many medications are used outside a license in the UK but within a strict criteria for your safety.

We recommend that you purchase a blood pressure machine to use at home. Taking your blood pressure before, during and after treatment will help you to keep an eye on things in case the medication starts to impact your blood pressure. We can then advise accordingly based on the readings. We would recommend taking your blood pressure once a week whilst using Minoxidil for hair loss treatment.

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