Minoxidil
Mechanism :
It is an anti-hypertensive drug with powerful vasodilator properties. It is used in the treatment of hypertension in children with renal disorders. It is also used to treat hair loss in adults as a topical agent.
Indication :
- Severe hypertension (in addition to beta blocker and diuretic)
Contraindications :
Pheochromocytoma, Use with caution in porphyria.
Dosing :
1 month-12 years:
Initial: 200 mcg/kg (Max: 5 mg/day) and then increase to 0.25-1 mg/kg/day orally 1-2 times a day (Max: 50 mg/day).
12-18 years:
Initial: 5 mg orally per day. Maintenance: 2.5-80 mg/day or every 12 hours. Max: 100 mg/day.
Increase every 3 days by 100-200 mcg/kg in those <12 years to a max of 1 mg/kg/day and by 5-10 mg/day to a max of 100 mg/day in those >12 years.
Adverse Effect :
Hypertrichosis, abnormal ECG, pericardial effusion, hypotension, pulse changes, headache, dizziness, sodium and water retention, tachycardia, weight gain, rash.
Interaction :
Antihypertensive Agents: Additive to other antihypertensive agents.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Start with small doses and titrate according to response. |
| 10-20 | Start with small doses and titrate according to response. |
| <10 | Start with small doses and titrate according to response. |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Dialysed. Dose as in GFR<10 mL/min |
| HD | Dialysed. Dose as in GFR<10 mL/min |
| HDF/High flux | Dialysed. Dose as in GFR<10 mL/min |
| CAV/VVHD | Dialysed. Dose as in GFR=10-20 mL/min |
Hepatic Dose :
No dose adjustments are recommended. Adjust dose as per clinical response.