Short answer: Topical minoxidil (Rogaine) is sold over the counter to regrow hair on the top of the scalp. Minoxidil tablets are approved only for severe high blood pressure, and the tablet label says hair growth is not an approved use.12 In one 24-week trial in men, oral 5 mg was not shown to be better than topical 5%.3
| Oral minoxidil (tablets) | Topical minoxidil (Rogaine) | |
|---|---|---|
| FDA status for hair loss | Not approved; the label says hair growth is not an approved indication2 | Approved for over-the-counter sale to regrow hair14 |
| Approved use | Severe high blood pressure not controlled by a diuretic plus two other drugs2 | Hair regrowth on the top of the scalp (vertex) in men; on the top of the scalp in women15 |
| Strengths | 2.5 mg and 10 mg tablets2 | Men: 5% foam or solution. Women: 5% foam or 2% solution1654 |
| Label directions | For blood pressure, from age 12: 5 mg once a day to start, usually 10 to 40 mg a day, at most 100 mg2 | Men's foam: half a capful twice a day. Women's foam: half a capful once a day. Solutions: 1 mL twice a day1564 |
| Boxed warning | Fluid around the heart, sometimes progressing to tamponade, and worsened angina; usually given with a beta blocker and a diuretic2 | None; ask a doctor first if you have heart disease1 |
| Body hair growth | Thicker, darker body hair in about 80% of people on tablets, within 3 to 6 weeks2 | Stop and ask a doctor if unwanted facial hair grows1 |
| Half-life | Average plasma half-life 4.2 hours2 | Not given on the label1 |
| When to judge it | Not labeled for hair2 | Men: stop if no regrowth in 4 months. Women's foam: stop if none in 6 months15 |
Yes, in one randomized trial in men. Penha and colleagues gave 90 men aged 18 to 55 with male pattern hair loss either oral minoxidil 5 mg daily plus a placebo solution, or 1 mL of topical minoxidil 5% twice daily plus a placebo pill, for 24 weeks; 68 finished. Neither the men nor the investigators knew who got which.3
The authors concluded that oral minoxidil 5 mg did not show superiority over topical 5% in this trial. In the oral group, 49% had increased body hair and 14% had headache.3 This was a small, single-clinic trial, and 5 mg is a dose from the trial, not a label dose for hair.
The minoxidil tablet label is written for severe high blood pressure. It says use of the tablets, in any form, to promote hair growth is not an approved indication, and that minoxidil should be given under close supervision, usually with a beta blocker and a diuretic.2 Taking tablets for hair loss is off label and is a decision for you and a prescriber.
Topical minoxidil is sold over the counter under FDA approval, with Drug Facts directions for adults 18 and older.15
More detail: minoxidil tablet side effects, the minoxidil tablet dosing schedule, the Oral Minoxidil and Topical Minoxidil guides, and Propecia side effects if you are weighing finasteride too.