Starting minoxidil tablets

This guide is for people who have decided, with a doctor, to try low-dose minoxidil tablets, or who are about to have that conversation. For background on how the tablets compare with lotion and foam, read minoxidil: tablet or lotion? and the tablet section of our minoxidil guide.

Before you start: questions for your doctor

Minoxidil is a strong medicine for blood pressure. At the low doses used for hair, it is usually well tolerated, but it acts on the whole body.^1,3 A doctor will want to know about your heart and circulation before prescribing it. Be ready to talk about:

any heart condition, chest pain, heart rhythm problem or heart failure, now or in the past
your blood pressure, and any medicine you take for it
kidney problems
any swelling of the legs or fluid retention
all other medicines and supplements you take
for women: whether you are pregnant, breastfeeding or planning a pregnancy

Good questions to ask:

What dose will I start on, and will it change?
Do you want to check my blood pressure, pulse or weight before I start, or later?
Which side effects should make me call you, and which should make me seek urgent care?
When will we review whether it is working?
Should I keep using minoxidil lotion or foam as well?

How doses usually work

Doses for hair are much lower than for blood pressure, and they are set by your doctor. Many doctors start low and increase slowly if needed. Trials and studies have used a range of doses, up to 5 mg a day in the main trial in men.^2,1

Take the tablet at the same time each day. If you miss a dose, skip it and carry on as normal. Do not take two tablets to catch up, and do not change the dose on your own. If you split tablets to reach a small dose, ask your pharmacist how to do it accurately.

What to watch for

Most side effects are mild and some are expected. In the study of 1404 people:¹

Unwanted hair growth on the face or body was the most common, in about 15%. It is usually more noticeable in women. In the 2024 trial of men on 5 mg, it was much higher, at 49%.²
Light-headedness, fluid retention and a fast heartbeat were the most common reasons people stopped. Overall, 1.7% stopped because of side effects.
No life-threatening side effects were seen, but the study looked back at medical records and had no comparison group, so rare problems may be missed.

Call your doctor, but not urgently, if you notice mild ankle swelling, light-headedness when you stand up, headaches, or unwanted hair that bothers you.

Some people find it useful to note their weight once a week and their resting pulse now and then in the first months, and to bring the notes to their review.

What to expect month by month

Fig. 1 The first six months on minoxidil tablets1 square = 1 month

Months 1 to 2: some people shed more at first, as with lotion. This is when side effects such as light-headedness or swelling usually show up, so stay alert to them.
Months 3 to 5: fine new hairs may appear, and unwanted body hair may become noticeable.
Month 6: review the result with your doctor, using progress photos taken before you started. Six months is the usual point to judge minoxidil.⁴

Tablets and lotion together

Some doctors suggest keeping the lotion or foam alongside tablets, others switch completely. There is little trial evidence either way, so follow your doctor's advice. If you were using lotion and are switching, do not stop the lotion until the tablets have started, to avoid a gap.

If you stop

Like lotion, tablets work only while you take them. If you stop, expect any gain to fade over the following months, as it does when people stop minoxidil lotion.⁴ Unwanted body hair usually fades too. Talk to your doctor before stopping, especially if you take the tablets for any other reason.