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

December 2023 in “ Toxicology communications ”

Mir Nadeem Mazhar, Adrián Estrada, Alexander Zorn, Robert Madlinger, M Miglietta

minoxidil finasteride hypotension vasopressin midodrine IV fluids acute heart failure pulmonary edema Rogaine Propecia

From the encyclopedia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Studysummary This report describes a case of prolonged distributive shock attributed to minoxidil overdose, which involved intentional ingestion alongside trauma and NSAIDs, successfully managed with medications and hydration despite persistent low blood pressure. Our plain-language summary of this paper — not a Tressless recommendation.

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.

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