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Switching from topical minoxidil to oral minoxidil

So, let’s talk about how one would switch from topical minoxidil to oral minoxidil. I think; first, we’ve got to understand how minoxidil works.

Minoxidil basically acts as a stimulator; it stimulates hair growth, and it can be used topically or prescribed orally. Minoxidil works by shortening the telogen (resting) phase of your hair growth cycle and moving your hairs into the anagen (active growth) phase.

Topical minoxidil is freely available, and certainly, here in Australia, it’s available over the counter, and it does not require a prescription. Oral minoxidil, on the other hand, does require a prescription because it was formulated initially for something else; it was formulated as an antihypertensive medication, so not everyone that is on topical minoxidil is a candidate for oral minoxidil, and it’s something that you should speak to your prescribing physician about to make sure that you get your hair loss assessed by someone who knows what they’re talking about who can weigh up the pros and cons for oral versus topical because there are pros and cons to both sides.

Let’s just say you are on the topical and you want to switch to the oral; well, what are the factors that will influence that decision?

Well, one factor that may direct you to want to change is if you feel that the topical minoxidil is not as effective, and that can be because absorption is not great in any one individual. Sometimes, people have very thick scalps. Therefore the penetration of the medication through the skin is not significant.

Another reason is maybe there is a large area that requires treating and therefore, the concentration that you’re able to apply to the scalp is not sufficient and that you’ve got a good enough concentration gradient for it to get through, and certainly if you’ve got a large area that you’re trying to treat, it would take a lot of the topical lotion, liquid, or foam to cover that area which may result in it being quite expensive.

In that scenario, you may consider all right, let’s switch to an oral format, you’ve got to make sure that you’re a candidate for oral medication if you’ve got any history of cardiac abnormalities, cardiac problems, high blood pressure issues, low blood pressure issues, then that’s something that you want to talk through your prescribing physician with.

The short answer is how you would switch logistically from a topical to an oral where it’s very simple: you stop one and start the other; there’s no long-term phase-in phase-out required.

Is there going to be any issues with shedding that you’re going to experience when you’re switching between one formulation to another?

I think generally the answer to that is no; if you’ve been on topical minoxidil for a prolonged period you can, and we’ve spoken about this in the past; you can get shedding when you start on minoxidil if you’ve been through that you’re stable, and you know it’s everything’s going well switching to an oral format does not result in a greater deal of shedding at that point, so I think as long as it’s appropriate.

Again, I would advise you to make sure that you get this checked and speak to a prescribing physician about it. Then, the conversion is relatively easy; certainly, the change from one formulation to another is very simple and straightforward.

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