Minoxidil may be dangerous to kids

By Janice Neumann

(Reuters Health) - Minoxidil, best known as a hair-loss treatment, may cause dangerous side effects in kids who are accidentally exposed to it, say the authors of a recent case study from France.

After a little girl swallowed less than a teaspoon of the product, she was hospitalized with tachycardia and hypotension that persisted until the next day, report the authors, who call for child-proof bottles and sale of the drug by prescription only.

"This is a very powerful hypotensive agent, some milliliters can lead to severe hypotension in an infant," said Dr. Isabelle Claudet, lead author of the report November 25 online in Pediatric Emergency Care.

Claudet, who heads the pediatric emergency department at Children's Hospital in Toulouse, pointed out that Alopexy and Alostil - the brand names under which minoxidil is sold in France to treat hair loss - come with a pump dispenser, which is no longer child-proof once opened.

She told Reuters Health the drug should not be available either over-the-counter or on the internet. Claudet and her coauthors also want parents and dermatologists to be aware of the side effects in kids.

Minoxidil was originally marketed to lower blood pressure in hypertensive patients who had not responded to other medications. The drug has also been sold as a hair-growing solution for several decades.

Although generally considered safe, past research has shown that even a teaspoon placed on the scalp of an adult twice daily can cause rapid heartbeat, salt and water retention or, in some cases, heart attack, according to Claudet.

As a treatment for hair loss, the drug is typically sold in a 2% or 5% solution, according to the researchers. The standard dosage is one milliliter applied to the scalp twice daily.

The seven-year-old girl in this study swallowed a bit less than a teaspoon of Alopexy (5% minoxidil) and was brought to Claudet's emergency room after vomiting all night.

Her blood pressure on admission was 86/56 mm Hg, plummeting to 79/33 mmHg at one point. Her heart rate was 149 BPM. She was given saline, which had no immediate effect, but her blood pressure returned to normal on the second day.

The girl's mother said she had been giving her daughter cough syrup for two days, and in the middle of the night when she heard the girl coughing, the mother accidentally grabbed the wrong bottle from underneath her own bed and gave her child the spoonful of medicine.

The dosage the girl ended up swallowing was 10 to 100 times greater than the therapeutic dose at which minoxidil is used to treat hypertension in children, the study authors note.

The drug swallowed by the little girl was manufactured by Pierre Fabre Laboratories in Switzerland. Johnson & Johnson Healthcare Products, a division of McNeil-PPC, Inc sells Rogaine, a similar topical minoxidil solution, in North America.

"The main problem is that it is considered as a safe product because it is used for its hair effect, but people forget its main indication as a hypotensive agent," Claudet told Reuters Health by email.

A representative of Johnson & Johnson said their Rogaine brand products have "child-resistant features in most countries."

Peggy Ballman, director of communications for the J&J Consumer Group, wrote in an email, "The product packaging for minoxidil, the active ingredient in both men's and women's ROGAINE Brand products, includes an important warning to keep the product out of reach of children."

She added, "We believe the first line of defense against accidental ingestion is parental supervision, secure storage and ongoing safe use education."

Claudet said she hoped the case study sent a message to manufacturers and retailers of minoxidil about its risks for children.

SOURCE: http://bit.ly/12qqOOL

Pediatric Emergency Care 2014.

(c) Copyright Thomson Reuters 2014. Click For Restrictions - http://about.reuters.com/fulllegal.asp