Minoxidil Interactions: What to Know Before Using This Hair Loss Medication

If you’re experiencing hair loss, you might be wondering about your treatment options. One of the most effective hair loss treatments out there is minoxidil, which has been proven by decades of research to help regrow hair.

Minoxidil doesn’t usually come with side effects, and minoxidil interactions with other medications are unlikely. But still, getting a complete picture of its safety profile might help you decide if it’s the right treatment for you.

Read on to learn about minoxidil, its potential drug interactions and other medications for promoting hair growth. 

Hair loss is part of the natural three-phase hair growth cycle, which involves the anagen (growth) phase, the catagen (declining) phase, and the telogen (resting) phase.

According to the American Academy of Dermatology (AAD), you lose about 100 hairs daily from regular shedding. 

Ninety percent of your hair should be in the growth stage at any one time, with the remainder falling into the declining or resting phase. 

About 9 percent of your hair is in the telogen phase, when the hair follicles rest before beginning to grow again.

Hair loss happens when there’s an interruption in this cycle. Here’s what can happen:

• The telogen phase gets longer, so hair doesn’t return to the hair regrowth phase quickly enough to replace natural shedding.

• The hair follicle is destroyed beyond repair and can no longer go through the hair growth cycle.

So, if you’re experiencing hair loss—especially if it’s happening earlier than you anticipated—a proven treatment like minoxidil might be on your radar. 

Minoxidil (brand name Rogaine^®) is a non-prescription, FDA-approved topical medication that promotes hair growth and regrowth by restarting the growth phase in dormant hair follicles. There’s also oral minoxidil, which is sometimes prescribed off-label for hair loss.

Experts don’t fully understand how it works, but significant research shows it’s an effective way to boost hair growth and thickness. 

Topical minoxidil is available in a 5% strength foam or liquid solution, depending on your personal preferences. 

Okay, so this medication is effective for regrowing hair, but you’re wise to wonder about minoxidil’s drug interactions. 

Both over-the-counter (OTC) and prescription medications have the potential to interact with other substances, including supplements.

Thankfully, minoxidil comes with a minimal risk of harmful drug interactions overall—but that doesn’t mean it has zero risk (no medication does).  

While issues with either form of minoxidil are rare, drug interactions are more likely with oral minoxidil than with topical applications. 

Minoxidil and Other Medications

The most likely interaction type between minoxidil and other drugs is an additive effect on lowering blood pressure. 

In other words, minoxidil taken with certain other drugs may exacerbate hypotension (low blood pressure) and cause headache, dizziness, lightheadedness, fainting, or even coma. This includes both antihypertensives and drugs used for other purposes.

This is because minoxidil works by relaxing blood vessels to allow blood to pass through them more easily—which results in lower blood pressure. 

Below, we’ve listed some of the most likely medications to have this amplified effect on blood pressure: 

• Alprazolam (Xanax^®), used to treat anxiety and panic disorder

• Apomorphine, an anti-Parkinson’s drug

• Bupropion (Wellbutrin^®), used to treat depression and prevent seasonal affective disorder (SAD)

• Dexamethasone, a steroid used to treat inflammation

• Diphenhydramine (Benadryl^®), an antihistamine

• Lithium, for mood disorders like bipolar or mania

• Medications for hypertension (high blood pressure) like vasodilators, beta-blockers, and diuretics

• Mirtazapine (Remeron^®), an antidepressant

• Narcotic medications for severe pain management, like fentanyl, oxycodone, sufentanil, and nalbuphine

• Perphenazine, an antipsychotic used to treat symptoms of schizophrenia

• Remimazolam (Byfavo^®), used for procedural sedation in adults

• Sapropterin (Kuvan^®), which lowers levels of phenylalanine in the blood of people with phenylketonuria (PKU)

• Sildenafil (Viagra^®), used for erectile dysfunction

• Sodium nitrite, which treats cyanide poisoning

• Sotagliflozin (Inpefa^®), used to reduce the risk of death from heart failure

• Tizanidine, a muscle relaxant used to treat muscle spasms

• Treprostinil (Tyvaso^®), used to treat pulmonary arterial hypertension (PAH)

• Vamorolone (Agamree^®), a corticosteroid used to treat Duchenne muscular dystrophy 

• Zaleplon (Sonata^®), a sedative

Quick disclaimer: It’s important to note that this list of medications isn’t exhaustive. Talk with your healthcare provider or pharmacist to find out if it’s safe to use minoxidil with your current prescriptions. 

Other Possible Minoxidil Interactions

Minoxidil can also negatively interact with alcohol and lower your blood pressure. 

Additionally, it may not be safe to use minoxidil, even at a low dose, if you have:

• Congestive heart failure

• Ischemic heart disease

• An adrenal gland tumor known as pheochromocytoma

• Kidney failure or another condition that requires dialysis

• A recent history of heart attack

• Low blood pressure

Let a healthcare professional know if you have any of these conditions or regularly experience angina-like chest pain. They may be able to recommend an alternative hair loss treatment. 

Finally, systemic cyclosporin with topical minoxidil may worsen hypertrichosis, which is excessive hair growth that may occur all over the body. And using low-dose aspirin with topical minoxidil may reduce how effective minoxidil is at treating hair loss.

If you want to know about the common side effects of this medication, including potential serious side effects of minoxidil, check out our guide to minoxidil’s side effects. 

And one more FYI: There can actually be beneficial medication interactions, too — mixing topical minoxidil with other topical hair loss treatments like tretinoin may increase the benefits of both medications.  

There are a few other hair loss treatments you can consider if minoxidil doesn’t sound right for you. These include:

• Finasteride: This medication targets the hormone dihydrotestosterone (DHT), which contributes to male pattern baldness (aka androgenic alopecia). Using finasteride daily can reduce DHT levels by as much as 70 percent and encourage hair regrowth. 

• Saw palmetto: Evidence suggests this natural ingredient may help reduce DHT levels, especially when combined with finasteride. 

If you’ve been choosing whichever shampoo and conditioner is cheapest at the drugstore, you can make these daily grooming products work harder for you. Look for volumizing formulas containing ingredients like saw palmetto to target excess hair shedding and help encourage hair growth.

Want to learn more about shampoo for hair loss? Check out our guide to what to look for in men’s hair loss shampoo.

Minoxidil is an effective, FDA-approved treatment for hair loss. But to recap, here’s what you need to know about potential Rogaine interactions:

• Like any medication, minoxidil can interact with some over-the-counter and prescription drugs.

• Medications like diuretics and antidepressants can amplify the blood pressure-lowering effects of minoxidil. However, interactions are more likely with oral minoxidil than topical minoxidil.

• Minoxidil might not be right for you if you have certain medical conditions like heart or kidney disease.

• If minoxidil solution or foam isn’t an option, other effective hair loss treatments are available. 

If you’re experiencing hair loss and want to try minoxidil, it’s a good idea to first get some medical advice from a healthcare professional. They can help determine why you’re shedding more strands than usual and whether minoxidil is right for you. 

Our DHT and male hair loss guide is a great place to learn about male pattern balding, and we’ve also put together a guide on how minoxidil and finasteride can work together to stop hair loss.