What should you expect in switching from 5mg oral minoxidil once daily, to a 2.5mg pill in the morning and a 2.5mg pill at night

Question

I have been taking oral minoxidil for almost 3 years now, and for two I’ve been on 5mg. For most of that time, I took my 5mg all at once in the morning. But a couple months ago, I started doing 2.5 twice a day. I have a hair transplant coming up in a few weeks and I’m scared that this switch has made me worse off. I’ve been severe NW4 if not NW5 and I noticed a lot of hair shedding last night and today. I understand shedding is usually normal, but I don’t have much left to shed. I’m worried

Anna Chacon, MD, FAAD · Answer

Thank you for your question. Switching the dosing schedule of oral minoxidil from a single 5mg dose in the morning to 2.5mg twice daily is generally considered a safe adjustment and can sometimes help in minimizing side effects while maintaining the therapeutic effect. However, it's understandable to have concerns, especially with an upcoming hair transplant.

Here are a few important points to consider:

Shedding Phase:

Temporary Shedding: It’s not uncommon to experience a shedding phase when adjusting the dosage or frequency of minoxidil. This shedding is usually temporary and is often a sign that the medication is working to promote new hair growth.
Dosage Consistency:

Steady Levels: Splitting the dose to 2.5mg twice daily can help maintain more consistent levels of the medication in your bloodstream, potentially providing a more stable environment for hair growth.
Upcoming Hair Transplant:

Consult Your Surgeon: It’s crucial to discuss any medication changes with your hair transplant surgeon. They can provide specific advice tailored to your situation and ensure that your treatment plan is optimized for the best results.
Monitoring Side Effects:

Watch for Reactions: Keep an eye on any new or worsening side effects. If you notice any significant changes, it’s important to report these to your healthcare provider promptly.
Long-Term Benefits:

Continued Use: Oral minoxidil is generally effective for long-term use in managing hair loss. The adjustment in dosing schedule should not negatively impact the overall benefits of the medication.
Patience is Key:

Gradual Improvement: Hair growth treatments often require patience. It can take several months to see noticeable improvements, even after a change in dosing.
While shedding can be alarming, it is often a normal part of the hair growth cycle, especially when making changes to your treatment regimen. However, given your concerns and the upcoming hair transplant, it’s best to stay in close communication with your healthcare provider to ensure you’re on the best possible path for your hair restoration journey.

Best of luck with your upcoming procedure!

Best regards,

Ross Kopelman, DO · Answer

It’s understandable to be concerned, especially with your hair transplant coming up soon. Splitting your 5mg dose into two 2.5mg doses (morning and night) shouldn’t negatively impact your overall hair growth. In fact, some patients find that splitting the dose helps reduce side effects while still maintaining the same effectiveness.
That said, the shedding you’re experiencing is likely part of a normal shedding phase. When switching dosages, it’s not uncommon to see some shedding as your hair follicles adjust. This shedding usually means that old, weaker hairs are making way for newer, stronger ones. Even though it feels concerning when you don’t have much hair left, this process is typically temporary and should stabilize.
In preparation for your upcoming hair transplant, keep up with the current minoxidil regimen and try not to worry too much about this temporary shedding&mdash;it’s often part of the hair growth cycle.

Jacquelline Leva, DO · Answer

Worsening hair loss Can be due to various factors, normal hair shedding as you stated 100-150 hairs about, extreme diet changes, stressful events, fungal infections, certainly adding or changing medications can affect hair loss...so I would ask whatyour transplant surgeon reccomends, I can't imagine will be that much different still getting 5mg.

Jeff Donovan, MD, PhD · Answer

Well, be sure to have a full evaluation. sure it could be the switch but what about the other 100-200 causes. Many many many people in many parts of the world have had covid in the last 3-4 months and this is always a consideration for shedding. so is stress, thyroid problems, diets weight loss and others. plus. there is no better time in the year than July/Aug for humans to shed hair. see an expert!

What should you expect in switching from 5mg oral minoxidil once daily, to a 2.5mg pill in the morning and a 2.5mg pill at night

Answers (4)

Answer: Shedding

Answer: Shedding

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What should you expect in switching from 5mg oral minoxidil once daily, to a 2.5mg pill in the morning and a 2.5mg pill at night

Answers (4)

Answer: Shedding

Answer: Shedding

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Everything you need to know about Hair Loss Treatment

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