Minoxidil interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Many psychotherapeutic and CNS-active agents (e.g., anxiolytics, sedatives, hypnotics, antidepressants, antipsychotics, opioids, alcohol, muscle relaxants) exhibit hypotensive effects, especially during initiation of therapy and dose escalation. Coadministration with antihypertensives and other hypotensive agents, in particular vasodilators and alpha-blockers, may result in additive effects on blood pressure and orthostasis.

  What to do: Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Some authorities recommend avoiding alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

  8 sources

  1. Sternbach H "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol 11 (1991): 390-1
  2. Shook TL, Kirshenbaum JM, Hundley RF, Shorey JM, Lamas GA "Ethanol intoxication complicating intravenous nitroglycerin therapy." Ann Intern Med 101 (1984): 498-9
  3. Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139
  4. Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6
  5. Rodriguez de la Torre B, Dreher J, Malevany I, et al. "Serum levels and cardiovascular effects of tricyclic antidepressants and selective serotonin reuptake inhibitors in depressed patients." Ther Drug Monit 23 (2001): 435-40
  6. Cerner Multum, Inc. "Australian Product Information." O 0
  7. Pacher P, Kecskemeti V "Cardiovascular side effects of new antidepressants and antipsychotics: new drugs, old concerns?" Curr Pharm Des 10 (2004): 2463-75
  8. Andrews C, Pinner G "Postural hypotension induced by paroxetine." BMJ 316 (1998): 595

Conditions

Conditions in which Minoxidil needs care, as documented in this source.

• Heart Failure

  Major

  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.

  1 source

  1. "Product Information. Loniten (minoxidil)." Pharmacia and Upjohn (2002):

• Myocardial Ischemia

  Major

  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.

  4 sources

  1. Miller DD, Love DW "Drug therapy reviews: evaluation of minoxidil." Am J Hosp Pharm 37 (1980): 808-14
  2. Bennion SD "Chest pain and abnormal electrocardiogram associated with minoxidil." Mil Med 147 (1982): 367-8
  3. Campese VM "Minoxidil: a review of its pharmacological properties and therapeutic use." Drugs 22 (1981): 257-78
  4. "Product Information. Loniten (minoxidil)." Pharmacia and Upjohn (2002):

• Pheochromocytoma

  Major

  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.

  2 sources

  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 (2002):

• Kidney Failure, Chronic

  Moderate

  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.

  3 sources

  1. 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
  2. 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
  3. "Product Information. Loniten (minoxidil)." Pharmacia and Upjohn (2002):

Therapeutic duplication

Drug classes that overlap with Minoxidil, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• peripherally acting antihyperten

  The recommended maximum number of medicines in the 'peripherally acting antihypertensives' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'peripherally acting antihypertensives' category.

  Example product in the source data (US market): Hydralazine/isosorbide dinitrate

• peripherally acting antihyperten

  The recommended maximum number of medicines in the 'peripherally acting antihypertensives' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'peripherally acting antihypertensives' category.

  Example product in the source data (US market): Hydralazine/hydrochlorothiazide/reserpine

• peripherally acting antihyperten

  The recommended maximum number of medicines in the 'peripherally acting antihypertensives' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'peripherally acting antihypertensives' category.

  Example product in the source data (US market): Hydralazine/hydrochlorothiazide