LONITEN ® Minoxidil

LONITEN ® is a drug based on minoxidil

THERAPEUTIC GROUP: Antihypertensives - substances with action on arteriolar smooth muscle.

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications LONITEN ® Minoxidil

LONITEN ® can be used in the treatment of hypertension refractory to normal antihypertensive therapies.

To ensure a good antihypertensive effect, it would be appropriate to combine LONITEN ® antihypertensive drugs with direct action on the central nervous system and loop diuretics.

Its active ingredient, but not the drug in question, is also used topically in the treatment of androgenetic alopecia.

Mechanism of action LONITEN ® Minoxidil

LONITEN ® taken orally, is rapidly absorbed in the gastro-enteric tract, for about 95% of the total dose. Minoxidil, the active ingredient of LONITEN ® reaches its peak plasma around the second hour, despite the first effects in terms of pressure are observed already after half an hour. Subsequently, around the fourth hour, the drug is eliminated mainly via the kidney after a hepatic metabolism.

The hypotensive action of LONITEN ® is inevitably due to its active principle minoxidil, able to act selectively on arteriolar smooth muscle cells, facilitating the opening of potassium channels and causing a hyperpolarization that prevents the contraction of these cells, thus exercising a muscle relaxant and spasmolytic action.

However, in order for the pressure control induced by LONITEN ® to be constant and lasting, it is necessary to administer it in synergy with drugs that inhibit the adrenergic system (preferably beta blockers, otherwise clonidine or alpha methyl-dopa), and with loop diuretics, to prevent two associated effects: increased heart rate and salt and water retention.

Studies carried out and clinical efficacy

1 MINOXIDIL DOES NOT GUARANTEE REDUCTION OF LEFT VENTRICULAR HYPERTROPHY

Left ventricular hypertrophy is a very frequent condition, important as a predictor of cardiovascular events, such as myocardial infarction, coronary artery disease and heart failure. The same condition is worsened by the presence of hypertension, which exposes the left ventricle to more work. For this reason, most antihypertensive drugs, partly reducing cardiac work, can guarantee a gradual improvement in left ventricular hypertrophy. However, studies show that some active ingredients known for antihypertensive effects, such as hydralazine and minoxidil, do not lead to any improvement on left ventricular hypertrophy.

2. MINOXIDIL IN REFRACTORY HYPERTENSION

The study shows that in 22 patients suffering from hypertension, with systolic blood pressure values above 190mmHg and with impaired renal function, minoxidil therapy resulted in an average pressure drop of about 40mmHg in six months of treatment, with a prolonged duration for subsequent 18 months. Some of these patients observed for another 6 years, did not show any type of deterioration of renal function, even if already partially compromised.

3. MINOXIDIL AND CLINICAL USE

Despite the use of minoxidil is accompanied by numerous side effects, such as increased heart rate - dangerous for the condition of cardiac ischemia - increased hydro-salline retention with peripheral edema, hirsutism and hypertrichosis, remains today one of the most effective therapies in management of the hypertensive patient refractory to common therapies, and in the patient with even severe nephropathy.

Method of use and dosage

LONITEN ® 5 mg tablets of minoxidil : the doses prescribed for antihypertensive therapy tend to range from 5mg to 40mg a day, even if the maximum expected dose reaches 100mg / day.

Generally we recommend a starting dose of 5mg / day, and then provide a gradual increase of 5mg at a time every 3 days. In order to keep blood pressure levels as constant as possible, it would be advisable to divide the daily dose into several administrations.

The choice of dosage, in any case, should be made by the doctor following a careful evaluation of the pathological condition of the patient and the possible association with other antihypertensive drugs.

IN ANY CASE, BEFORE TAKING LONITEN ® Minoxidil THE REQUIREMENT AND CHECK OF YOUR DOCTOR IS NECESSARY.

Warnings LONITEN ® Minoxidil

As mentioned, LONITEN ® monotherapy could lead to an increase in water-saline retention and an increase in heart rate, exposing the patient to potential risks. In order to reduce the incidence of adverse events, constant monitoring of blood pressure, heart rate and electrolyte balance would be advisable. Given the aforementioned potential side effects, a combined therapy with diuretics and antihypertensive drugs acting on the central nervous system is generally used, combined in some cases with a low salt diet.

Cases of hypertrichosis, normalized only a few months after stopping therapy, have also been described during minoxidil therapy.

LONITEN ® contains lactose, therefore it could give rise to problems of various kinds, even serious ones, in patients suffering from intolerance to lactose or galactose, lactase deficiency or glucose-galactose malabsorption.

PREGNANCY AND BREASTFEEDING

At present there are no particularly significant data regarding the effects of LONITEN ® on pregnant women, while the teratogenic effect on the fetus appears to have been avoided.

Therefore its use should be avoided in the first trimester of pregnancy, and limited afterwards to cases of real need and under strict medical supervision.

Minoxidil, the active ingredient of LONITEN ® is secreted in breast milk, so it is advisable to stop breast-feeding during drug therapy.

Interactions

The antihypertensive action of LONITEN ® can be sustained and supported by the simultaneous administration of loop diuretics and antihypertensive drugs directed on the central nervous system.

At the same time, incorrect dosage of the aforementioned drugs could lead to hypotensive crises.

Contraindications LONITEN ® Minoxidil

We do not recommend the use of LONITEN ® in hypersensitive individuals to one of its components, and in patients suffering from pheochromocytoma, given the possible inductive effect in the secretion of catecholamines determined by the hypotensive action of the active principle minoxidil.

Undesirable effects - Side effects

Various side effects - such as tachycardia, peripheral edema, pericardial effusion - may occur during monotherapy with LONITEN ®

In the literature, rare cases of hematocrit and hemoglobin reduction, thrombocytopenia, haematochemical alterations, gastro-enteric reactions and hypotension are also described.

More frequent, on the other hand, is minoxidil-induced hypertrichosis, an effect used as a therapeutic basis for the treatment of androgenetic alopecia.