Good question.
I bought 1 bottle of the 6% minoxidil version for the hell of it with my last order.
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Minoxidil 6% Plus - FAQs
Q. What is 6% Minoxidil-Plus?
A. 6% Minoxidil-Plus is an exclusive Regrowth medication for the treatment of alopecia androgenetica (male pattern baldness), containing 6% minoxidil and 0.1% finasteride by weight. 6% Minoxidil-Plus is available in 65mL bottles. Each mL of 6% Minoxidil-Plus contains 60mg of minoxidil and 1mg finasteride.
Q. Why is 6% Minoxidil-Plus so highly recommended?
A. This is an economically priced hair growth product that contains a combination of the only two medications approved by the U.S. FDA for the treatment of male pattern baldness. 6% Minoxidil-Plus is a clear, light amber colored, extremely stable solution, containing 6% minoxidil and 0.1% finasteride that has a proven efficacy in the treatment of male pattern baldness.
Q. Since finasteride inhibits only the Type 2 5-alpha reductase, how do you know that the serum DHT is decreased with the use of topical finasteride?
A. Independent studies from other researchers (e.g. Rushton and Ramsay in an article in the British Journal of Medicine) have shown that topical finasteride lowers the serum DHT by inhibiting its synthesis in the prostate. "A 0.05% formulation of topical finasteride was well absorbed and lowered the serum dihydrotestosterone concentration by up to 40%".
Q. Should 6% Minoxidil-Plus be used by patients who are or who are not taking oral finasteride?
A. 6% Minoxidil-Plus can be used as the sole treatment for treating male pattern baldness or as a supplement to patients who are already using the oral finasteride, as oral finasteride 1mg/daily lowers the amount of DHT in the scalp by only 38% (Roger S. Rittmaster, M.D. at the American Academy of Dermatology (AAD) meeting in San Francisco, March 2000).
Q. Are there any special precautions relating to the 65mL bottles of 6% Minoxidil-Plus?
A. Because of the volatility of the ethyl alcohol, the bottle should be tightly capped when the solution is not being used. The solution is extremely stable within a wide range of temperatures and has been tested to be unaffected in the range of 10o to 200o Fahrenheit (-12o to 93o Centigrade) for short exposures. 6% Minoxidil-Plus is best kept at room temperatures.
PHARMACOLOGY
Q. How well are the active ingredients of 6% Minoxidil-Plus absorbed into the dermis of the scalp?
A. Ethyl alcohol is one of the few substances that freely permeates the skin (the permeability coefficient of ethanol across human skin in 8 x 10 –8 mol/cm2) and it carries the minoxidil and finasteride in with it. The penetration enhancing effects of ethanol play a significant role in minoxidil absorption. The effective absorption of topical minoxidil and finasteride depends on the vehicle composition. Greater effects are achieved when the fraction of the volatile component increases, especially at ethanol concentrations higher than 50% (and maximizing at 90%).
Q. Does 6% Minoxidil-Plus leave any kind of residual on the scalp when it dries?
A. Yes, but very little. The non-greasy formula allows for twice/day application without untoward cosmetic results. The finasteride is completely absorbed. This residual reservoir of minoxidil provides a beneficial source for the continued absorption of minoxidil even after the 6% Minoxidil-Plus has dried on the scalp.
FORMULATION
Q. How much of the base of 6% Minoxidil-Plus is ethyl alcohol?
A. The base solution consists of 50% ethyl alcohol and 20% propylene glycol with a trace of phosphoric acid.
Q. Does 6% Minoxidil-Plus have a ‘greasy’ feel?
A. The base is 50% ethyl alcohol, so the 6% Minoxidil-Plus solution absorbs fairly quickly.
Q. Why wasn’t retinoic acid added to 6% Minoxidil-Plus?
A. Retinoic acid was an important additional ingredient, when minoxidil solutions only contained 2% minoxidil (Rogaine). With higher concentration minoxidil solutions, there is no need for retinoic acid, which can have more drawbacks than benefits. Retinoic acid acts as a chemical peel and can cause drying, scaling, redness and irritation of the scalp. Moreover, chronic use of retinoic acid makes the skin more sensitive to sun damage.
DIRECTIONS FOR USE
Q. How is 6% Minoxidil-Plus applied to the scalp?
1. 1mL of 6% Minoxidil-Plus should be applied to the scalp twice daily, preferably at least 8 hours apart. Each bottle of 6% Minoxidil-Plus is accompanied with a calibrated 1mL medicine dropper that allows the patient to conveniently apply 1mL of 6% Minoxidil-Plus solution onto the scalp. Dropper: Place the tip of the dropper onto the scalp and squeeze the rubber bulb to release a small amount of 6% Minoxidil-Plus. Divide the total 1mL quantity into as many doses as are required to moisten/wet the scalp in all the areas affected by male pattern baldness. The fingertips can be used to spread the liquid within the desired areas or to restrict the spread to other areas. Wash hands thereafter.
Q. Is there an alternative method of application other than using a dropper?
A. Regrowth offers a 2oz. plastic bottle with a custom fitted dauber applicator with protective overcap. 6% Minoxidil-Plus can be transferred to the applicator bottle and dispensed by simply inverting the dauber and gliding it across the scalp. It has been established that four side-to-side passes over the scalp dispenses approximately 1 mL of solution. This is, by far, the most convenient way to apply topical minoxidil solutions. Although the amount being dispensed cannot be precisely calibrated, if only enough liquid is applied to moisten the affected areas, there is minimal chance of utilizing excessive amounts of 6% Minoxidil-Plus.
Q. Should the scalp be dry or wet when 6% Minoxidil-Plus is applied?
A. The scalp can be dry or hydrated, but the scalp should not be wet to the degree of diluting or washing off the minoxidil/azelaic acid/finasteride.
Q. How soon after applying 6% Minoxidil-Plus can one shower or shampoo?
A. For optimal absorption of the minoxidil and finasteride, allow 1½ to 2 hours. The high concentration of ethyl alcohol in the base allows for rapid absorption of the minoxidil and finasteride.
Q. Will wetting the hair for styling purposes affect the efficacy of 6% Minoxidil-Plus?
A. No, assuming you are not going to get the scalp so wet that you will wash off the 6% Minoxidil-Plus.
Q. Will blow-drying the hair affect the efficacy of 6% Minoxidil-Plus?
A. It would be advisable to blow-dry the hair before the application of 6% Minoxidil-Plus. Otherwise, blow-drying will cause most of the alcohol in the 6% Minoxidil-Plus to evaporate, preventing absorption of the medicines.
Q. What do I do if a precipitate forms in my bottle of 6% Minoxidil-Plus?
A. Since the 6% Minoxidil-Plus is a saturated solution of minoxidil, there may be rare occasions when a precipitate will form in the bottle. If and when this happens, the capped bottle of 6% Minoxidil-Plus should be placed in water that has been heated to gently simmering temperatures and shaken vigorously. As long as the bottle of 6% Minoxidil-Plus is kept tightly capped, it can be kept in the heated water for prolonged periods, until all the minoxidil goes back into solution.
USE WITH OTHER PRODUCTS
Q. Can 6% Minoxidil-Plus be used in conjunction with Xandrox15-Plus?
A. Yes. Apply 1mL of 6% Minoxidil-Plus in the morning and 1mL of Xandrox15-Plus at least 8 hours later.
Q. Should one use the 5% Spironolactone Lotion in conjunction with 6% Minoxidil-Plus?
A. For most patients, it shouldn’t be necessary. The finasteride in 6% Minoxidil-Plus should provide adequate reduction of DHT in the scalp. However, there would be no contraindication with concomitant use of spironolactone.
Q. Should one use 6% Minoxidil-Plus, if he is already taking oral finasteride?
A. There is no contraindication to doing so. Oral finasteride 1mg/daily lowers the amount of DHT in the scalp by only 38%. The use of finasteride will lower the scalp DHT even further.
Q. Should a patient initiate treatment for male pattern baldness with 6% Minoxidil-Plus?
A. Yes. It’s the single best medication for treating male pattern baldness. If after six months of treatment with this regimen, the improvement is not satisfactory, then the patient may want to consider the use of Xandrox15-PLUS at night on those areas of the scalp with inadequate regrowth of hair.
SIDE EFFECTS AND CONTRAINDICATIONS
Q. What is the margin of safety from having systemic effects due to minoxidil when dosing with 6% Minoxidil-Plus daily?
A. Minoxidil requires a serum concentration of 20 ng/mL to have any hemodynamic or other systemic effect in the human body. Allowing for the average 1.4% absorption (range 0.3 - 4.5%) of minoxidil from the topical application of 1 mL of 6% Minoxidil-Plus, there will be a serum concentration of minoxidil of ~4 ng / mL of minoxidil in the serum. So, there is an estimated 10-fold safety margin from any systemic effects of minoxidil due to the use of 6% Minoxidil-Plus, when it is used once/day as recommended. For optimal results, it is suggested that topical minoxidil be applied twice/day.
Q. What are the systemic effects and possible side effects of minoxidil use?
A. Oral minoxidil is used as a medication to lower the blood pressure, so the most common systemic effects are tachycardia (increased heart rate) and orthostatic hypotension (dizziness on standing). Other side effects may include fluid retention,
chest pain and facial edema. There have been rare reports of pericardial effusion (fluid collection around the heart) with the use of oral minoxidil.
Q. Wouldn’t the amount of alcohol used in 6% Minoxidil-Plus be harmful?
A. Not at all. At most, 2mL of 6% Minoxidil-Plus would be applied daily. The percutaneous absorption from a 50% ethyl alcohol solution would be less than 50mg. By comparison, this is the amount of alcohol in less than 1 mL of wine (10% alcohol by volume). Skin exposure is not a safety concern.
Q. What should a patient do, if he or she experiences any of the systemic side effects of minoxidil?
A. The patient should immediately cease using all topical solutions, which contain minoxidil. Side effects should abate within days. Report your side effects immediately to Regrowth (
RichardLeeMD@earthlink.net). Following cessation of the topical application of minoxidil, approximately 95% of systemically absorbed minoxidil is eliminated within four days.
Q. Are there patients who should avoid using 6% Minoxidil-Plus?
A. Yes. Patients with any history of heart disease should not use 6% Minoxidil-Plus. Also patients who have a known adverse reaction to minoxidil or finasteride should avoid using 6% Minoxidil-Plus.
