Minoxidil Oral Administration Guidelines

Pharmacological Context

The absorption of minoxidil does not depend on competitive transport mechanisms with amino acids or nutrients, unlike medications such as levodopa 1

In patients with Wolff-Parkinson-White syndrome, the annual risk of sudden cardiac death is 2.2%, more than 10 times higher than that of the general population with WPW (0.15-0.2%) 2
The American Heart Association recommends that beta blockers are contraindicated (Class III) in patients with WPW who present with ventricular preexcitation during atrial fibrillation, as they can accelerate conduction through the accessory pathway and precipitate ventricular fibrillation 2, 4
The use of minoxidil can cause significant reflex tachycardia, which can trigger atrial fibrillation with rapid conduction through the accessory pathway, leading to ventricular fibrillation and sudden cardiac death in patients with WPW 2, 3

The American College of Cardiology recommends catheter ablation of the accessory pathway as the first-line treatment for symptomatic WPW, with a success rate of >95% and complications <1-2% in experienced centers 2, 3
If a patient is already receiving minoxidil, it is recommended to immediately contact the treating cardiologist to discuss discontinuation of the medication 4