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Minoxidil Disease Interactions

There are 4 disease interactions with minoxidil:

Major

Minoxidil (Includes minoxidil) ↔ fluid retention/congestive heart failure

Major Potential Hazard, Moderate plausibility. Applies to: Fluid Retention, Congestive Heart Failure, Pericardial Tamponade

Minoxidil tablets must usually be administered with a diuretic 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 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. Caution and close monitoring is advised in patients with preexisting congestive heart failure. Pericardial effusion, occasionally with tamponade, has been also observed in about 3% of treated patients not on dialysis, especially those with inadequate or compromised renal function. In some cases, the pericardial effusion was associated with a congestive heart failure, or marked fluid retention. 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.

Major

Minoxidil (Includes minoxidil) ↔ ischemic heart disease

Major Potential Hazard, High plausibility. Applies to: Ischemic Heart Disease

Minoxidil commonly produces reflex tachycardia. Angina pectoris may develop or worsen as a result of increased oxygen demands associated with increased heart rate and cardiac output. Therapy with minoxidil should be administered cautiously in patients with coronary insufficiency. The concomitant administration of a beta-adrenergic blocker is often helpful to prevent tachycardia and increased myocardial workload. Minoxidil has not been studied for use in patients who have had a recent myocardial infarction (within the preceding month). It is possible that the reduction of arterial pressure and increase in heart rate produced by minoxidil may further limit blood flow to the myocardium. Minoxidil must be administered under close supervision, also usually given with a diuretic, to prevent serious fluid accumulation. Patients with malignant hypertension and those already receiving guanethidine should be hospitalized when minoxidil is first administered so that they can be monitored to avoid too rapid, or large orthostatic, decreases in blood pressure.

References

  1. Bennion SD "Chest pain and abnormal electrocardiogram associated with minoxidil." Mil Med 147 (1982): 367-8
  2. Campese VM "Minoxidil: a review of its pharmacological properties and therapeutic use." Drugs 22 (1981): 257-78
  3. Miller DD, Love DW "Drug therapy reviews: evaluation of minoxidil." Am J Hosp Pharm 37 (1980): 808-14
  4. "Product Information. Loniten (minoxidil)." Pharmacia and Upjohn, Kalamazoo, MI.
View all 4 references
Major

Minoxidil (Includes minoxidil) ↔ pheochromocytoma

Major Potential Hazard, High plausibility. Applies to: Pheochromocytoma

The use of minoxidil is contraindicated in patients with known or suspected pheochromocytoma. Minoxidil may stimulate the secretion of catecholamines from the tumor through its antihypertensive action.

References

  1. Lowenthal DT, Affrime MB "Pharmacology and pharmacokinetics of minoxidil." J Cardiovasc Pharmacol 2 (1980): s93-106
  2. "Product Information. Loniten (minoxidil)." Pharmacia and Upjohn, Kalamazoo, MI.
Moderate

Minoxidil (Includes minoxidil) ↔ renal failure/dialysis

Moderate Potential Hazard, High plausibility. Applies to: Renal Dysfunction

Patients with renal failure or on dialysis may require a lower dosage of minoxidil as 21% of a dose is excreted unchanged in the urine. Close medical supervision is advised to prevent exacerbation of renal failure or precipitation of cardiac failure.

References

  1. Lowenthal DT, Onesti G, Mutterperl R, Affrime M, Martinez EW, Kim KE, Busby P, Shirk J, Swartz C "Long-term clinical effects, bioavailability, and kinetics of minoxidil in relation to renal function." J Clin Pharmacol 18 (1978): 500-8
  2. Halstenson CE, Opsahl JA, Wright CE, et al "Disposition of minoxidil in patients with various degrees of renal function." J Clin Pharmacol 29 (1989): 798-802
  3. "Product Information. Loniten (minoxidil)." Pharmacia and Upjohn, Kalamazoo, MI.

Minoxidil drug interactions

There are 157 drug interactions with minoxidil

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.