Adam Friedman/ Getty
A dermatologist, who prescribes minoxidil for hair loss and also takes the drug himself, shared his advice for people who are unable to fill their prescriptions, in the wake of a shortage in parts of the US.
Dr. Adam Friedman, professor and chair of dermatology at George Washington University, has been taking minoxidil for thinning hair for three months. Friedman didn't lose any hair because of the shortage, partly because he was already taking finasteride, another hair loss drug.
But his struggles with accessing the drug inspired him to carry out a survey published in the Journal of Drugs in Dermatology, which found only 29.6% of 277 pharmacies polled in the District of Columbia, Maryland, and Virginia in the first week of October had enough oral minoxidil 10-mg tablets for a 30 day supply.
Friedman shared the three steps he took that enabled him to get a prescription despite the shortage.
Friedman didn't have any special access to drugs as a physician, but knows it's possible to send prescriptions to different pharmacies if a drug isn't in stock at his usual one.
He was able to fill his prescription by contacting multiple pharmacies to see if they had minoxidil in stock before rushing to the store before they ran out.
Although this worked for him, he said "it was definitely extra work" and involved a lot of frustration from waiting around at pharmacies that didn't end up having any minoxidil in stock.
Compounding pharmacies make prescriptions to fit a patient's specific needs, whether that is altering the dosage of a medication, or changing ingredients to omit things a patient is allergic to.
Friedman said that compounding pharmacies can also be useful in a drug shortage, because they can make drugs that are close, but not the same as, the original, allowing people in need to "pivot."
Medications from compounding pharmacies don't tend to be included in medical insurance plans, but they can be a good option if you can afford the out-of-pocket cost, he said.
It's important to note that compounded drugs are not FDA-approved, so they may not be as safe or be of the same quality and effectiveness as approved drugs, and the FDA has found "troubling conditions" when inspecting certain compounding facilities.
Friedman said that there is a dose range for minoxidil, meaning taking anywhere between 0.625 to five milligrams per day can be effective.
"There's no perfect dose," he said, so "if a patient can get a two week supply of two and a half milligrams, I'll tell them, go down to 0.625 milligrams to spread it out. That will help because at least they're staying on an amount of it that can actually still be effective."
Friedman said that if you stop taking minoxidil, you won't lose all your hair immediately. Some people might experience a shedding of hair called telogen effluvium, due to the stress on the body of stopping a medication abruptly, he said, but the hair will start to grow back in two months.
However, he said: "the whole process that was miniaturizing your hair in the first place starts up again. So once you stop these medicines, you will start thinning again. It's not a fast process, but the hard work you've been putting in will start to get reversed," he said.
He acknowledged that although hair loss isn't a "medically threatening" condition, it can greatly impact people's quality of life. So, he said, knowing about and being prepared for what might happen if you stopped taking minoxidil can help mitigate the mental and emotional effects of a shortage.
Insider previously reported on the alternative products you can use instead of minoxidil.
