What it is
Low-dose oral minoxidil is the same active compound as topical minoxidil but taken as a tablet, typically at doses between 1.25 mg and 5 mg daily. It is prescribed off-label for hair loss — meaning it is not specifically FDA-approved for this use, but clinicians may prescribe it based on emerging evidence and clinical judgment.
Who it's commonly prescribed for
Oral minoxidil is often considered for patients who have difficulty with consistent topical application, experience scalp irritation from topical formulations, or have diffuse thinning that may benefit from systemic delivery. It requires a prescription and periodic monitoring by a clinician.
Typical timeline
Response timelines are similar to topical minoxidil. Some patients report noticing changes as early as 2 to 3 months, with more substantial improvement at 6 to 12 months. The systemic route may produce a more even distribution of effect across the scalp, though individual responses vary.
Common side effects
Because oral minoxidil is absorbed systemically, its side-effect profile is broader than the topical form. Clinicians typically start at the lowest effective dose.
- Increased body or facial hair (hypertrichosis)
- Mild fluid retention
- Slight decrease in blood pressure
- Elevated heart rate
- Dizziness or lightheadedness
- Ankle swelling (uncommon at low doses)
Questions to ask a clinician
Because this is an off-label use, an informed discussion with your clinician is especially important.
- Why are you recommending oral over topical minoxidil for me?
- What dose will we start at, and will it be adjusted?
- How often should my blood pressure and heart rate be checked?
- Can I take oral minoxidil alongside other hair loss medications?
- What symptoms should prompt me to stop and contact you?
- Is this appropriate given my cardiovascular history?