Minoxidil Topical Solution

Abstract

Minoxidil hair formulation is commonly used for the treatment of male or female androgenic alopecia. This over-the-counter product is wrongly considered safe. The ingestion of a few milliliters by a child can lead to significant intoxication. We report a case of significant intoxication after the ingestion of topical minoxidil (Alopexy; Pierre Fabre Laboratoires, SA, Switzerland). A 7-year-old girl, who accidentally ingested a teaspoon of minoxidil hair solution, presented to the pediatric emergency department for emesis. At admission, she had a blood pressure of 86/56 mm Hg and a pulse of 149 beats per minute. Hypotension lasted 40 hours with the lowest value 24 hours after ingestion (79/33 mm Hg). She presented electrocardiogram changes (sinus tachycardia and flattening T-waves) but normal cardiac enzymes. Infusion of 20 mL/kg of normal saline fluid had no hemodynamic effect. Her blood pressure normalized on day 2. Minoxidil topical solution is an unsafe product for children. This formulation should be strictly kept out of reach of children and manufacturers should enhance child-resistance security of packaging. The over-the-counter availability must be questioned.

Successful management of minoxidil 5% toxicosis in 2 cats from the same household

“…The most notable is hypotension that is, at times, refractory to vasopressor therapy and similar cardiopulmonary manifestations as described in this report's cases. Overwhelmingly, treatment is successful with appropriate vasopressor, fluid, and oxygen therapies 10–12 . Much of the available veterinary literature was gained during drug development but proposed that clinical toxicosis is secondary to both global vasodilation and subsequent increase in myocardial oxygen demand, as well as a myocardial injury due to hemorrhage from coronary arterial dilation and capillary rupture 13–16 …”

“…Minoxidil undergoes biotransformation via glucuronidation to inactive metabolites that are then excreted via glomerular filtration 1,2–14 . The active form of minoxidil (minoxidil N‐O sulfate) is derived via sulfonation.…”

“…Overwhelmingly, treatment is successful with appropriate vasopressor, fluid, and oxygen therapies. [10][11][12] Much of the available veterinary literature was gained during drug development but proposed that clinical toxicosis is secondary to both global vasodilation and subsequent increase in myocardial oxygen demand, as well as a myocardial injury due to hemorrhage from coronary arterial dilation and capillary rupture. [13][14][15][16] Minoxidil undergoes biotransformation via glucuronidation to inactive metabolites that are then excreted via glomerular filtration.…”

“…[13][14][15][16] Minoxidil undergoes biotransformation via glucuronidation to inactive metabolites that are then excreted via glomerular filtration. 1,[2][3][4][5][6][7][8][9][10][11][12][13][14] The active form of minoxidil (minoxidil N-O sulfate) is derived via sulfonation. Felids do not rely on glucuronidation and instead, extensively biotransform via sulfonation.…”

Developmental Neurotoxic Effects of Percutaneous Drug Delivery: Behavior and Neurochemical Studies in C57BL/6 Mice

“…Dermatosis is a chronic disease characterized by intense itching, chloasma and eczematous lesions, etc. Emollient and cream afford some symptomatic and temporary relief, but disease exacerbations often require long-term treatment with topical delivery, the prolonged and larger-body application of which can be associated with dermal atrophy, local swelling and other side effects, such as emesis and diarrhea [ 1 , 2 ]. Experimental researchers also emphasized that dermal absorption of some drugs through topic administration, occupational contact and cosmeceutical exposure can cause a number of local effects, including irritant and allergic contact dermatitis [ 3 , 4 ].…”