Minoxidil solution (Tugain) 5% is a medicine used to treat common hereditary hair loss, such as male pattern baldness. Its component product is minoxidil, which was initially used to treat severe high blood pressure due to its vasodilator effect.  Due to its effect of hair growth, thickening, and pigmentation that were found in patients who orally administered minoxidil, it is also now used as a hair loss treatment for those with genetic hair loss, or androgenic alopecia, which is the only FDA-approved indication.

It has also been used in the following conditions:

• Alopecia areata (autoimmune disease that attacks the hair follicles)
• Hair loss induced by chemotherapy
• Hair transplant
• Scarring alopecia (inflammatory condition that destroys hair follicles)
• Monilethrix (rare inherited disorder characterized by sparse, dry, and/or brittle hair that often breaks before reaching more than a few inches in length)

What does Minoxidil solution (Tugain) 5% contain?

Tugain solution 5% contains its active ingredient, minoxidil which belongs to a group of medicine called vasodilators.

How does Minoxidil solution (Tugain) 5% work?

Tugain Solution 5%, when applied to the scalp, helps to increase the blood flow. This increased blood flow provides more nutrition and oxygen to the hair follicles which prevent hair cell death and enhances new hair growth.

It also acts by shortening the telogen, or resting, phase, causing the quiescent hair follicles to enter prematurely into the anagen, or growth, phase. The shortening of the telogen phase may induce telogen effluvium (excessive hair shedding) after the initiation of minoxidil therapy. Also, minoxidil extends the duration of the anagen phase. Lastly, increased hair length and diameter are the clinical effects of minoxidil.

The initial effects of minoxidil occur after approximately eight weeks of treatment, and maximal effects take place after four months.

Who cannot take Minoxidil solution (Tugain) 5%?

This drug is not recommended for the following:

• Female patients (limited to 2%)

According to some studies, it can cause unwanted hair growth especially to women. Some experience facial hair growth when they use minoxidil. That can happen if the medication trickles down onto your face or simply as a side effect when you apply it only to your scalp. The risk is lower for women who use the 2% concentration of the drug, as opposed to the 5% or 10% concentration designed for men. 

• Patients under the age of 18

Topical minoxidil is not FDA-approved for people under the age of 18 due to lack of research. Although not approved, it has been used with success. 

• Pregnant or possibly pregnant women and lactating (limited to 2%)

Animal studies did not show teratogenicity (ability to cause defects in developing fetus), but it was found to be fetotoxic (decreased conception rate). 

• Patients who are allergic to this drug and its components
• Patients with treated or untreated hypertension
• Patients without genetic factors or unknown cause for hair loss
• Patients with scalp abnormalities, such as erythema, inflammation, infection, irritation or pain, psoriasis, sunburn, and scalp shaved patients
• Patients with hair loss related to childbirth (limited to 2% and 3%) 

How should you take Minoxidil solution (Tugain) 5%?

Topical minoxidil is available in solution or foam formulation. You may view Additional Information tab for recommended doses.

1. Apply 1 ml of minoxidil topical solution to the scalp every 12 hours. The total daily dose should not exceed 2 ml. 
2. Apply to the entire area of hair loss, starting from the center of the hair loss area.
3. For best results, the minoxidil topical solution should be left on the scalp for about 4 hours. For evening application, it is recommended to apply 2-4 hours before bedtime to allow the solution to dry. When applying, do not massage the solution into the scalp, but apply it lightly.
4. Using a hair dryer may speed up the drying of the solution, making it less effective. It should not be mixed with hair oil.
5. The drug should not be used more than twice a day, taken orally, and applied to other parts of the body to avoid side effects and the risk of unwanted hair growth.
6. Even if you use it more often or for a longer period of time, it will not affect hair growth. Even if you forget to use it daily, the total daily dose is only 2ml.
7. Hands should be washed immediately after applying minoxidil topical solution to the fingertips.
8. In order to see the hair loss treatment effect, it must be used for at least 45 days. If there is no improvement after 1 year, the treatment must be discontinued.
9. Minoxidil is easily discolored. It is rare for the solvent to change color, but if there is no problem with the ingredients, so you can use it with confidence.

You should use this solution continuously to maintain hair growth. If your condition does not improve after using it for 4 to 6 months, consult your doctor.

What if you miss a dose?

If you missed a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double dose.

What if you take too much?

Taking 1 or 2 extra doses is unlikely to harm you. However, if you feel unwell, talk to your healthcare provider.

Also, if it accidentally gets in your eyes, mouth, or on any broken skin, thoroughly rinse with water.

What are the side effects of Minoxidil solution (Tugain) 5%?

Minoxidil is generally well tolerated. However, it may cause some unwanted effects. These side effects are mild and do not need medical attention. They go away as your body adjusts to the medicine. Consult your doctor if they persist or worsen.

Common side effects are:

• Itching or skin rash
• Erythema or redness
• Dermatitis or skin dryness
• Hirsutism (facial hair growth in women) outside the area where this drug was applied
• Folliculitis
• Local irritation including burning sensation and peeling

What other precautions should be taken?

Children

Safety and efficacy of this medication on children have not been established.

Elderly

Research has not demonstrated problems in this age population. However, studies have shown that the medicine works best in younger patients who have a short history of hair loss. Minoxidil has not been studied in patients older than 65 years of age .

Pregnancy

Some adverse effects were observed in animal reproductive studies, so minoxidil is not recommended for pregnant women.

Breastfeeding

Studies have shown that this medication is excreted in the breastmilk. Hence, it is not advised for breastfeeding women.

Drug-Disease Interactions

Caution is needed if you have any of the following conditions:

• Pulmonary hypertension
• Chronic heart failure
• Recent heart attack
• Angina pectoris
• Kidney disease

Drug-Drug Interactions

Let your doctor know if you are taking other topical medical preparations, like corticosteroids, retinoids, or occlusive ointment bases as they may increase absorption of the drug.

Alcohol

No interaction established. You may drink alcohol while on this medication.

Driving

No interaction established. It does not impair your ability to drive.

Diet and Lifestyle

You can eat and drink normally while taking this medication.

How should you store Minoxidil solution (Tugain) 5%?

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
• Keep out of the reach of children and pets.
• Do not keep outdated medicine or medicine no longer needed.
• Flammable: Keep away from fire or flame.

Quick Tips

• Long-term use of minoxidil is necessary to maintain the clinical results, as these effects regress with drug discontinuation.
• You may initially experience hair loss during the first two weeks of application. This is normal; it will resolve on its own. However, tell your doctor if your hair loss continues after 2 weeks. Also, tell your doctor if your hair growth does not increase after using minoxidil for 4 months.
• It should only be applied directly to the scalp. If it accidentally comes in contact with your eyes, nose, or mouth, flush the area thoroughly with cool tap water.
• Make sure that it does not trickle down on your face as it may cause undesirable facial hair growth.
• Do not shampoo your hair or use a hairdryer for 4 hours after applying the solution as it can reduce the effectiveness of the medicine.

What company produces Minoxidil solution (Tugain) 5%?