Severe and Refractory Hypotension After Intentional Minoxidil Overdose: A Case Report

This case report describes an 18-year-old male who experienced severe and prolonged hypotension after intentionally ingesting a topical minoxidil-finasteride spray, along with NSAIDs and a detergent pod. Despite initial trauma and minimal bleeding, the patient's hypotension was attributed to the minoxidil overdose. He was managed with phenylephrine, vasopressin, midodrine, and IV fluids, and required intensive hemodynamic monitoring. The patient developed acute heart failure and pulmonary edema but eventually recovered and was discharged after 12 days. This case highlights the severe and prolonged effects of minoxidil overdose and the importance of appropriate vasopressor support and fluid resuscitation.