Why Oral Minoxidil Isn't a Common Choice for Hair Loss Treatment

95% of hair loss is treatable.

And topical minoxidil is one of the most effective hair loss treatments available. Combined with finasteride, it's the first-line treatment recommended by dermatologists.

And best of all, you don't need a prescription to buy it.

However, topical minoxidil may not work for everyone. And, occasionally, it can cause irritation of the scalp.

That's where oral minoxidil comes in. While it's not as commonly prescribed as topical minoxidil, it's becoming an increasingly popular alternative—particularly for men who haven't had success with topical treatment or prefer the convenience of a daily pill.

In this article, we'll share everything you need to know about oral minoxidil: what it is, how well it works, its side effects, and how to get it with Essential Clinic.

What is oral minoxidil?

Minoxidil is a medication originally developed in the 1970s as a treatment for hypertension. It relaxes smooth muscles in blood vessels, which dilates them. As researchers were studying its effects, they noticed that a common side effect of patients was hair growth, and this led to its development as a hair growth medication.

It was approved for use under the brand name Rogaine in the 1980s.

Cut to today: minoxidil is one of the most effective and popularly used hair loss treatments out there. It's most commonly used as a topical solution applied directly to the scalp, though it's also available as a foam and gel treatment.

Oral minoxidil has the same active ingredient as the topical solution, but it has been formulated as a pill that you ingest.

What is oral minoxidil used for?

At higher doses (typically 10-40 mg daily), oral minoxidil is used to treat high blood pressure.

At lower doses (typically 1.25-5 mg daily), it's increasingly prescribed off-label for hair loss treatment—particularly when topical minoxidil isn't effective, causes scalp irritation, or is difficult for patients to apply consistently.

Why isn't oral minoxidil the first choice for hair loss?

There are several reasons why dermatologists typically recommend topical minoxidil before oral:

1. Topical has more extensive research: Topical minoxidil has been studied for hair loss since the 1980s, while research on low-dose oral minoxidil for hair loss is more recent (though growing rapidly).

2. Prescription requirement: In Canada, you can buy topical minoxidil over the counter at any pharmacy. Oral minoxidil requires a prescription and medical oversight.

3. Systemic vs. localized effects: Topical minoxidil works primarily where you apply it. Oral minoxidil works throughout your body, which means it can cause unwanted hair growth in other areas (hypertrichosis).

4. Historical concerns about side effects: At the high doses used for blood pressure (10-40 mg), oral minoxidil can cause serious cardiovascular side effects. While these are rare at the low doses used for hair loss (1.25-5 mg), the association has made some doctors cautious about prescribing it.

That said, for the right candidates—particularly men who haven't responded to topical treatment or find it inconvenient—oral minoxidil can be an excellent option.

Oral minoxidil vs. topical minoxidil

Topical minoxidil remains the first-line treatment, but oral minoxidil offers distinct advantages for certain patients:

Six reasons someone might choose oral minoxidil:

1. Convenience and Ease of Use: Oral minoxidil is taken in pill form, making it easier to use compared to applying a topical solution or foam. For those who find the daily application of topical minoxidil messy, time-consuming, or inconvenient, an oral option can be more straightforward.

2. Potential for Better Efficacy: Some studies suggest that oral minoxidil might be more effective for certain individuals, especially those who do not respond well to the topical version. This could be due to better systemic absorption, leading to increased stimulation of hair follicles. In contrast, topical application can lead to variable absorption due to factors like improper application or scalp conditions.

3. Fewer Scalp-Related Side Effects: Topical minoxidil can sometimes cause scalp irritation, itching, flaking, or allergic reactions in some users. Oral minoxidil bypasses the scalp, potentially avoiding these localized side effects.

4. Easier to Stick With: If you're likely to forget topical applications, a once-daily pill may improve consistency and results.

5. Less Greasiness and Build-Up: Some users dislike the greasy residue or build-up left by topical minoxidil, which can also affect hair styling and appearance. Oral minoxidil eliminates this issue entirely.

6. Safer for Pet Owners: Topical minoxidil is toxic to cats. With oral minoxidil, there's no risk of your pet coming into contact with the medication.

Effectiveness of oral minoxidil

So how effective is oral minoxidil for hair loss?

Recent research shows that low-dose oral minoxidil is an effective treatment for androgenic alopecia (male pattern hair loss). While topical minoxidil has more total studies, the evidence base for oral minoxidil has grown significantly in recent years.

A comprehensive 2021 review analyzed available studies and concluded that oral minoxidil is effective for male pattern hair loss and female pattern hair loss. A 2025 meta-analysis of multiple studies confirmed these findings, concluding that "the efficacy of oral minoxidil is comparable to that of topical minoxidil in terms of improving hair density and terminal hair density in patients with AGA."

One study found that low doses (as little as 0.25 mg daily) produced meaningful results for men with androgenic alopecia, though most dermatologists now prescribe 2.5-5 mg daily for optimal effectiveness.

Bottom line: Oral minoxidil works. It's a proven treatment option, particularly for men who haven't had success with topical minoxidil or prefer the convenience of a daily pill.

Does oral minoxidil work for female pattern hair loss?

Yes, it appears to. Several studies have found that low-dose oral minoxidil can be an effective treatment for female hair loss, with results comparable to topical treatment.

However, women should be particularly aware of the risk of hypertrichosis (unwanted facial and body hair growth), which can be more bothersome for women than men.

Does oral minoxidil work better than topical minoxidil?

There are relatively few studies that directly compare the effectiveness of topical vs. oral minoxidil.

In a 2024 randomized clinical trial published in JAMA Dermatology, 5 mg oral minoxidil performed comparably to 5% topical minoxidil (applied twice daily) for male pattern hair loss, with oral showing slight superiority on the vertex area.

In an earlier study, 1 mg of oral minoxidil was found to be as effective as 5% minoxidil topical solution for female pattern hair loss, with no statistically significant difference in their effectiveness.

The choice between oral and topical often comes down to personal preference, tolerability, and individual response rather than one being definitively "better" than the other.

What's the typical dose of oral minoxidil for hair loss?

Most dermatologists prescribe 2.5-5 mg daily for hair loss treatment, though some start patients at a lower dose (1.25 mg) and increase based on response and tolerability. Essential Clinic offers oral minoxidil starting at these evidence-based doses.

This is significantly lower than the 10-40 mg daily doses used for blood pressure treatment, which is why the side effect profile is much more favorable at hair loss doses.

How long does oral minoxidil take to work?

Oral minoxidil begins to work immediately, but it will usually be three to six months before you notice any changes to your hair. You'll usually notice results after six months and you'll likely achieve the "final" results after about a year.

This timeline is very similar to topical minoxidil.

Does oral minoxidil cause beard growth?

There's very little research specifically on the use of oral minoxidil to improve beard growth.

One side effect of oral minoxidil is excessive hair growth, including on the face and body, so it could lead to beard growth in some people. In one small study of 25 patients, 13 (52%) reported perceiving hair density increases in their beard.

However, the research is very, very limited.

Should you combine oral minoxidil with finasteride?

Many dermatologists recommend combining minoxidil with finasteride for maximum hair regrowth. Minoxidil stimulates hair follicles, while finasteride blocks DHT (the hormone that causes hair loss). Together, they attack hair loss from two different angles.

Essential Clinic offers a 2-in-1 finasteride + minoxidil pill that combines both treatments in a single daily tablet.

Learn more: 2-in-1 Finasteride + Minoxidil Pill: Complete Guide

Oral minoxidil side effects

Is oral minoxidil safe?

Yes, at the low doses used for hair loss (under 5 mg per day), oral minoxidil has been shown to be safe and well-tolerated by most healthy people. A large 2021 safety study of 1,404 patients found that serious side effects were rare at these low doses.

However, there is a risk of side effects from oral minoxidil, and it's important to be aware of them.

Common side effects

Hypertrichosis (excessive hair growth) is the most common side effect of oral minoxidil, occurring in 20-30% of patients. A study of 435 patients on low-dose oral minoxidil found that approximately 35% experienced some degree of hypertrichosis. This means you may notice increased hair growth on your face, arms, back, or other areas of your body—not just your scalp.

For many men, mild facial or body hair growth is a manageable tradeoff. For women, this can be more concerning. If unwanted hair growth becomes bothersome, you can discontinue oral minoxidil and the extra hair will stop growing.

Other common side effects include:

• Temporary hair shedding (typically during the first 2-8 weeks of treatment)
• Fluid retention and mild swelling of the lower legs
• Lightheadedness or dizziness
• Increased heart rate
• Headaches
• Minor weight gain (usually due to fluid retention)
• Skin rash
• Itchy eyes

Most of these side effects are mild and manageable. Your doctor may recommend starting at a lower dose and gradually increasing to minimize side effects.

Serious side effects (rare at low doses)

At the higher doses used for blood pressure treatment (10-40 mg daily), oral minoxidil can cause serious side effects such as pericarditis (inflammation of the lining around the heart) and significant fluid retention that can lead to weight gain.

These serious side effects are extremely rare at the low doses (1.25-5 mg) used for hair loss. The 2021 study of 1,404 patients found no cases of serious cardiovascular side effects at hair loss doses in otherwise healthy individuals.

That said, patients taking oral minoxidil do require regular follow-up by a medical professional to monitor for any potential issues.

If you experience any of the following while taking oral minoxidil, stop the medication and contact your doctor immediately:

• Chest pain
• Severe or sudden swelling
• Rapid or irregular heartbeat
• Difficulty breathing
• Significant, unexplained weight gain (more than 5 pounds in a week)

Can too much minoxidil cause hair loss?

Yes and no.

One of the common side effects of minoxidil (whether topical or oral) is that it can cause temporary shedding when you first start treatment. This happens because minoxidil accelerates your hair growth cycle, causing older hairs to fall out so new, thicker hairs can grow in.

This shedding phase typically lasts 2-8 weeks and is actually a sign the medication is working.

However, taking more than your prescribed dose won't accelerate permanent hair loss—it will just increase your risk of side effects without providing additional benefit. Always stick to your prescribed dose.

Does oral minoxidil cause weight gain?

Some people experience weight gain as a side effect of oral minoxidil, typically due to mild fluid retention rather than fat gain. This is more common at higher doses used for blood pressure treatment and less common at the low doses used for hair loss.

If you notice significant or sudden weight gain while taking oral minoxidil, contact your doctor.

Oral minoxidil long term side effects

We are aware of very few studies that examine the long-term side effects of minoxidil for hair loss.

In one study, there were very minimal side effects noted for patients after a year of treatment. In another study on oral minoxidil for hypertension, minoxidil was found to have "relatively few side effects."

Your doctor will likely recommend periodic check-ins to monitor for any potential side effects.

When to not use minoxidil

Minoxidil is safe and well-tolerated for most people, but there are some people that should be cautious with its use. Ensure your doctor is aware of any of the following conditions before they give you a prescription for oral minoxidil:

• Angina or recent heart attack
• Heart disease
• Heart failure
• Pheochromocytoma
• Liver impairment
• Pregnancy or are breastfeeding (for women)

You should also inform your doctor if you:

• Are currently taking blood pressure medications (oral minoxidil can interact with these)
• Are using topical minoxidil (you should discontinue topical before starting oral to avoid doubling your minoxidil dose)
• Have a history of significant fluid retention or swelling

Also, note that neither oral nor topical minoxidil has been evaluated for, or approved for, use with children.

Do I need a prescription to buy oral minoxidil in Canada?

Yes, you do need a prescription to buy oral minoxidil in Canada. Essential Clinic makes getting a prescription simple through our online consultation platform.

Where can I buy oral minoxidil in Canada?

Essential Clinic offers oral minoxidil with delivery across Canada. Our online platform lets you complete a medical consultation, get a prescription if appropriate, and have your medication shipped discreetly to your door.

Does Essential Clinic sell oral minoxidil?

Yes. We offer oral minoxidil (Generic Loniten®) for hair loss through our online platform.

Our licensed Canadian healthcare professionals will review your medical history, answer your questions, and determine if oral minoxidil is appropriate for you—all without leaving your home.

You can also get our 2-in-1 finasteride + minoxidil pill if you want to combine a DHT blocker with minoxidil in one daily tablet for maximum hair regrowth potential.

Why choose Essential Clinic?

• 100% online consultations with Canadian clinicians
• Discreet delivery directly to your door
• Ongoing support from our medical team

Find the best hair loss treatment for you

Not sure whether oral minoxidil, topical minoxidil, finasteride, or a combination treatment is best for your situation?

No worries, we can help. Just start an online hair loss visit and we will guide you with an appropriate hair loss regimen.

References

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_{Beach, R. A. (2018). Case series of oral minoxidil for androgenetic and traction alopecia: Tolerability & the five C's of oral therapy. Dermatologic Therapy, 31(6).}

_{Desir, N., Desai, A. D., & Lipner, S. R. (2024). Increased interest in oral minoxidil for hair loss treatment following publication of August 2022 New York Times Article: A Google Trends analysis. Skin Appendage Disorders, 10(1), 46-49.}

_{Fazal, F., Malik, B. H., Malik, H. M., Sabir, B., Mustafa, H., Ahmed, M., ... & Saad, M. (2025). Can oral minoxidil be the game changer in androgenetic alopecia? A comprehensive review and meta-analysis comparing topical and oral minoxidil for treating androgenetic alopecia. Skin Health and Disease, 5(2), 95-101.}

_{Gupta, A. K., Talukder, M., & Shemer, A. (2024). Efficacy and safety of low-dose oral minoxidil in the management of androgenetic alopecia. Expert Opinion on Pharmacotherapy, 25(2), 139-147.}

_{Jimenez-Cauhe, J., Saceda-Corralo, D., Rodrigues-Barata, R., Hermosa-Gelbard, A., Moreno-Arrones, O. M., Fernandez-Nieto, D., & Vaño-Galvan, S. (2019). Effectiveness and safety of low-dose oral minoxidil in male androgenetic alopecia. Journal of the American Academy of Dermatology, 81(2), 648-649.}

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_{Penha, A. F., Takahashi, M. D., Barreto, T., & Ramos, P. M. (2024). Oral minoxidil vs topical minoxidil for male androgenetic alopecia: A randomized clinical trial. JAMA Dermatology, 160(6), 601-607.}

_{Perera, E., & Sinclair, R. (2017). Treatment of chronic telogen effluvium with oral minoxidil: a retrospective study. F1000Research, 6.}

_{Pirmez, R., & Salas-Callo, C. I. (2020). Very-low-dose oral minoxidil in male androgenetic alopecia: a study with quantitative trichoscopic documentation. Journal of the American Academy of Dermatology, 82(1), e21-e22.}

_{Ramos, P. M., Sinclair, R. D., Kasprzak, M., & Miot, H. A. (2020). Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial. Journal of the American Academy of Dermatology, 82(1), 252-253.}

_{Randolph, M., & Tosti, A. (2021). Oral minoxidil treatment for hair loss: A review of efficacy and safety. Journal of the American Academy of Dermatology, 84(3), 737-746.}

_{Sanabria, B., Vanzela, T. N., Miot, H. A., & Ramos, P. M. (2021). Adverse effects of low-dose oral minoxidil for androgenetic alopecia in 435 patients. Journal of the American Academy of Dermatology, 84(4), 1175-1178.}

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This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.