Minoxidil is a potent vasodilator. At the low doses used for hair loss, the common effects are hypertrichosis, mild tachycardia, ankle swelling and occasional postural light-headedness; pericardial effusion is rare but is the reason the drug carries cardiac warnings.
A short history — chest pain, breathlessness, palpitations, known heart disease, other antihypertensives — and a baseline pulse and blood pressure take a minute. Patients should be told to report new swelling, breathlessness or a racing heart, and warned that facial and body hair may increase.
- Ask about cardiac symptoms and other blood pressure drugs before prescribing oral minoxidil.
- Record a baseline pulse and blood pressure.
- Warn about increased facial and body hair, the commonest reason patients stop.
- Tell patients to report ankle swelling, breathlessness or palpitations promptly.
Why it matters
A one-minute check catches the rare patient in whom a vasodilator is the wrong choice.
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