Minoxidil as a Sublingual Tablet

Note that the increasingly popular low-dose oral Minoxidil for hair loss (taken via ingesting pills or tablets) acts a bit differently compared to sublingual Minoxidil (taken via dissolving under the tongue). Read the bottom half of this post for more details. Top half is all updates.

Sublingual Minoxidil for Hair Loss Updates

Update: February 2023 — A HRN forum member named “Viney” is posting excellent details with photos of his hair regrowth from sublingual Minoxidil and Dutasteride. He sees a dermatologist at Sinclair Dermatology (Melbourne, Australia).

Update: January 2023 — I posted something on Twitter about sublingual Minoxidil possibly being more effective than oral Minoxidil. Below are the interesting responses from Dr. Corralo and Dr. Bhoyrul:

Sublingual vs Oral Minoxidil

Sublingual Minoxidil Sulfate

Update: December 2022 — Also see this thread on Twitter in relation to the same subject.

Update: September 2021 — A clinical trial of 40 male and female patients receiving sublingual Minoxidil (SM) for androgenetic alopecia just ended. Per the summary, SM produced a dose-dependent increase in mean terminal hair count of the frontal and vertex scalp and an improvement in hair density. There was no affect on blood pressure. Quote from reviewer Dr. Mirmirani:

“The authors suggest that sublingual Minoxidil (SM) may have better bioavailability and fewer hemodynamic effects by avoiding first-pass liver metabolism. Although the data in this study are positive, it will take more to convince me that it is significantly better than oral Minoxidil (OM). Very few of my patients on low-dose OM for hair loss discontinue the medication due to side-effects. The other consideration is cost. OM it is an inexpensive, generic drug, that is covered by medical benefits.”

Update: March 2021 — An excellent video presentation on sublingual Minoxidil from Dr. Bevin Bhoyrul from Sinclair Dermatology:

Update: July 2020 — Also from Sinclair Dermatology comes a case series report of 64 patients taking sublingual Minoxidil (0.45 mg per day) for pattern hair loss.

April 9, 2018

Sinclair Dermatology

Sublingual Minoxidil Delivery
Sublingual Minoxidil Delivery.

Earlier today, a reader named Chris posted a very interesting video about a new hair loss treatment from Australia that entails putting some kind of dissolvable listerine-style strip underneath the tongue. Chris asked me for my opinion about this treatment.

At first, I thought that this seemed like an obvious scam since the title of the video includes the word “breakthrough” in it. Moreover, the video does not even mention what ingredients are in the sublingual strip or patch itself.

However, since the famous Australian dermatologist Dr. Rodney Sinclair appears in the video, I decided to conduct further research. Dr. Sinclair (associated with “The Hairy Pill“) is an extremely well respected researcher in the hair loss world. In the above video, he is honest and clearly says that this treatment will not bring back hair in totally bald scalps.

Having said that, so far it seems that the results from this treatment on people who have moderate levels of balding have been very positive. And this got me curious about what magic concoction was in the strip itself?

Clinical Trial for Sublingual Minoxidil

I did not have to conduct much further research to figure out what this new potential breakthrough hair loss cure entailed. On Dr. Sinclair’s blog, the latest post from today discusses a new clinical trial they are conducting that is recruiting both men and women. Volunteers will be treated with low-dose oral Minoxidil that will be given as a sublingual tablet (which will dissolve under the tongue).

I would not be surprised if the tablet is actually the strip/patch that was shown in the video I posted earlier. It would be very uncomfortable to put an actual tablet underneath the tongue and wait for it to dissolve, unless the dissolution happened very rapidly. On the other hand, a strip would be much easier to keep in place underneath the tongue for a longer period of time.

I discussed oral Minoxidil for hair loss in detail last year. While I often use topical Minoxidil foam, I would not take the oral version as I do not want more body hair as a potential side effect. However, oral Minoxidil clearly seems to be a superior option to topical Minoxidil when it comes to hair growth benefits. Partly due to the sulfotransferase issue.

If you live in Australia or in the nearby vicinity, perhaps it is worth volunteering for these trials. Today I finally learnt the definition of “sublingual”.

Also make sure to read my post on extra strength Minoxidil 15 percent for other alternatives to regular dosage store-bought Minoxidil foam.

63 thoughts on “Minoxidil as a Sublingual Tablet”

  1. Worse delivery method than topical. The fact that it’s already an active ingredient means you’ll have more in the tissue of the scalp than systemically if you place it topically. You would just need to maybe place a little higher concentration topically. Think of it this way. You place 15% on scalp, 10% gets into tissue of scalp, 5% goes systemic. You take 10% sublingual, 10% goes systemic, 5% ends up in scalp tissue. This = no bueno

    1. Several renowned physicians have said that oral Minox works better than topical for hair growth.

      Make sure to read the below post:

      https://www.hairlosscure2020.com/oral-minoxidil-to-treat-hair-loss/

      Why would anyone prefer oral to topical if there are more risks with the oral? Only if there are also more benefits.

      My guess is that the amount of Minoxidil in the oral tablet or strip is much higher than the amount in each small quantity of the topical that you apply twice per day (a 2 ounce foam can is expected to last for a month with twice per day application).

      And some of the topical might not get fully absorbed into the scalp. Some might even evaporate before reaching the scalp skin dermis.

    2. A very late reply – but here it is anyway:

      Topical minoxidil doesn’t work for everyone. You have to have the required enzymes (SULT1A1) to respond to it when using it on the scalp.

      Oral minoxidil: you don’t need that enzyme as your liver will do that.

      I think in the USA you should be able to get yourself tested to see if you have the enzyme (haven’t found that in Australia yet). Probably worth it to avoid the side effects of the oral treatment.

      Cheers

    1. However i do not understand why administering this sublingually would be superior to just swallowing a tablet? Maybe minoxidil has an effect on the liver if taken long term

      1. sublingual or liquid absorbs faster and better than tablet. Multi vitamins are an example. Liquid absorbs better than tablet. Some people who take medication can do sublingual for better absorption. However, in the case of this, growing werewolf hair I think in most is not a viable trade off.

        1. I really want to know what mg of minoxidil is used and i will get the minoxidil tablets and try it myself. I am already a warewolf so not sure it will matter that much

          1. I have been taking 5mg per day for the past 200 days. The result is amazing. I was having a shedding phase for the first 3 weeks even though I had been using topical minoxidil for many years. Started to noticed the effect after using it for 2 months. It keeps improving and hope I will see a greater result in 12 months :)

  2. What are the effects on blood pressure, I wonder? I would certainly go in for this.

    Makes me wonder why we’ve never heard of a transdermal minox patch as an application method?

    1. The dose is much lower than what is used for blood pressure, so it is intended to make little effect on BP.

    2. My blood pressure (DBP) has been always low (70 to 75), prior to oral minoxidil. But after taking minoxidil orally, my blood pressure has further gone down to 60 to 70. It caused tiredness for the first 1 month, BUT now I am able to adapt to it, NO longer feel tired.

  3. Interesting. My proposal for a quick’n’dirty replacement: 0,02 to 0,2 ml of 5% minoxidil solution (1 to 10 mg of minoxidil) placed right under your tongue.

  4. So the trend is to switch the way we take the current Drugs and hope its much better?

    Oral Fin –> topical Fin
    Topical Minox –> oral Minox

    I dont think so! What we already know and what we need are Drugs wich target new mechanism in the hair Growth cycle. Inflammation, metabolism, autoimmune reaction, Growth factors, stem Cells and so on ….

  5. Sublingual minoxidil is equivalent to oral minoxidil, they are just different ways of getting systemic minoxidil. Many oral drugs make a sublingual version (eg, Zofran, Ambien, Claritin, etc). Systemic minoxidil does seem to work better than topical minoxidil but has greater propensity for side effects (albeit low).

    1. Generally spoken, yes. But I kept in mind, what Prof. Sinclair says about absorption in the linked video: “What we found is that if you put it under the tongue you can actually get it to deliver to the hair follicle before it’s broken down. So you can actually get by with much lower doses.”_So there could actually be a difference, maybe just a slight one, but his trial and further research will show.

      1. The administered dose is lower, but that is meaningless because the dose at the hair follicle and in the blood stream is the same.

        For example, using made up numbers:
        10mg administered sublingually -> 20% broken down -> 8mg arrives at the hair follicle and in the blood

        20mg administered orally -> 60% broken down -> 8mg arrives at the hair follicle and in the blood

        Thus you have to change the dose administered, but this has no practical effect on side effects or efficacy because the effective dose is the same.

  6. I am going to start dropping minoxidil (generic liquid) under my tongue unless someone talks me out of it. I cant see the ingredients would hurt, alcohol ppg and water.. I just need to figure out the dose

    1. Won’t kill you. I’ve been doing the same since January (dose 0,1ml 5% liquid solution i.e. 5mg). You can test up to 0,2ml without mandatory use of a diuretic.

        1. There really are no harmful ingredients: propylene glycole is actually permitted to be used as food additive (E490), not to talk of ethanol; and minoxidil, well let’s say the maintenance dose to treat hypertension is 10 to 40mg…

    1. Honestly, yes. I’ve been following the subject ever since it’s inception 2 years ago, the big thread on HLT. After following everything in detail this could potentially outclass the big 3. Surprised not more people talk about it here. Could be fantastic for earlier norwoods for regrowth and maintenance. We’ll know for sure the 14th.

        1. Actually there where Pictures and the way Brotzu Lotion works and effects essential parts of the Hair Growth System I expect it to be much better than the current Treatments. … But we will know soon. Fidia will present this Weekend and at least give some timeline and results. … I really think it has the potential to be the first new Treatment at market and will help till Next Level Treatments market in the next years.

    1. I’m sure of it and probably worse. The one side effect you can probably dodge is the dry scalp caused by the topical delivery compound. If that’s not an issue just pile on a higher concentration topically. You’ll be better off.

  7. Honestly I would not do the sublingual minox and it’s a little insulting to the intellect. We already have a tablet and liquid version. All that is happening, is a hamster wheel effect with the same treatments. I believe advodart is not approved for hair loss because Merk’s numbers are not going through the roof per year % wise on Propecia. Per speculation, but why would a company spend millions, go through the FDA, to have a drug approved like advodart and it’s not chart topping superior to Propecia? I believe that is why it is not worth a company to try and push it through.

    However, putting topical fin and sublingual minox….we already have the orals and topicals, so to me sublingual is not worth it. It’s like in thermodynamics……we only use about 25% of our energy. Say your car gets 20 M.P.G…..it should get 80. Why does it get 20? We….after over 100 years cannot perfect an old technology to utilize energy we have….fuel. Our engines only utilize 25% of the energy, we have yet to even master an old technology……so we move on to going green…hybrids etc. We can openly admit, we cannot perfect a good technology, but we move on. So do you see what I am getting at? We are trying to perfect old medications like minox and fin….we need to move on. In both, we have the oral and topical. They are mere side effects anyway, so of course we can’t perfect them.

    I think and I hope this analogy pushes people to think beyond minox and fin, and like any other industry, you simply can’t beat a dead horse or perfect something that is old. You see beyond that, great for the times, and move on. I mean don’t get me wrong( almost said wong….no pun intended Hasson and wong ), if we can perfect the engine and our fuel…I would be first in line to enjoy more Miles per gallon. In the meantime, we are having cars that can drive themselves, hybrid vehicles, and 5G. I think it’s about time, the hair loss moves forward( not on your heads of course…keep the hair you have ), forward with treatments. How do we help? If a new drug comes out and it invested millions and time…..if it is not better than what we got, let it fall flat on it’s face, don’t buy it…..no $$$. So runner up Brotzu. Last I known fidia can use some sales, I seen an article on 2017 they had layoffs. The only way to have integrity is a man of results, so you trust the man’s word. I think in hairloss, ppl because of duress( guilty ) , jump on the next thing. Lets reverse the mind set…..and get integrity back, ok it was never much there. Lets put integrity into hair loss. ….

    I mean, what made me write what I wrote is because some are wanting to put topical minox in their mouth. I am not slamming you for that thinking. It’s just are we really at this point? Does this sound like integrity? Or a hamster in that hamster wheel I mentioned? At this rate, we might as well take peptide versions of HGH to stimulate hair- ok, some bodybuilders actually report some regrowth…..however, do you see how far we are willing to stretch things? This is not a negative post, it’s just a post to get the hamster off the wheel and get some integrity and some thinking. I am sure Admin, will cover Brotzu after the italian conference. Look, I don’t even blame the thinking of ppl wanting to put topical minox in their mouth….however, to get to that point, I digress to what I wrote. Trust me and I get it. I have written several times about thinking getting on Topical Fin, Litan, and other ingredients in a topical. I have a derm who will write the script. I do note, my Endo does not like Propecia at all.

    So with that said, maybe few will read it…..please think twice before drinking your minox and realize what got us to this point. Maybe someone else can comment on Brotzu and Sheisedo…..etc. New ” Technologies”, if you will.

    – “With great power comes great responsibilities”
    – Uncle Ben…..Spiderman, 2002.

    1. That’s a well formulated and well written prompt that got me thinking. Thank you for that.

      I’d like to add some thoughts. We have two somewhat effective treatments – very effective for some, ineffective or intolerable for others (like me in case of fin). Your post got me thinking. So we have two treatments. What are the chances that really only two angles to this problem exist and we have found them? That’s against anything I believe in terms of science. We have made so much progress in other fields but almost nill regarding hair loss. Why is that? And I think your answer to that is dead on. That the problem ist that for whatever reason we keep using the same approaches we have.

      Regarding Brotzu. I don’t have a good feeling with this one. Can’t put my finger on it but I think it’s the way the company communicates (or doesn’t communicate) shows me there is something off.

      Again – kudos to you Derek for taking the time to write something thoughtful. There is so much crap and hype and desperation out there.

  8. @admin – Off topic I know but if Shiseido launch the workable cure in Japan at the end of the year if phase 2 works I am flying out to have it done and will report back. I have the cash and the time to get it done. I am a norwood 5.

    1. That would be great Scott. I would not expect them to launch anything till next year, but hope it works great whenever it is launched.

  9. @admin
    @nasa_rs
    I have some small aclaris news for you guys, ill post it tonight when i get some free time. Nothing big but real news none the less :)

  10. As a former patient at Sinclair Dermatology here in Melbourne Australia, I would say they are a really professional practice covering a wide range of skin disorders including hairloss. There is at least a one year wait to see Dr Sinclair if you want to see him in particular. They are widely regarded and recognized by the medical professionals here. In terms of hair loss, Sinclair take a look at your medical history and do a PSA blood test before they prescribe anything first. They compound their own Finasteride and Minoxidil in oral form in differing doses, either to be taken alone or together in one pill, depending on the patient. It works out to be a very low cost option also. I couldn’t tolerate Finasteride (of coarse I’m just ‘fear-mongering’ though hey) but I’m considering oral Minoxidil. My current doc went to a seminar late last year where Dr Sinclair was presenting results of some of his patients who were taking low dose oral Minoxidil and said they were impressive. He said the slides showed good regrowth in quite a few of the patients. Not just young ones either. It persuaded him to try the treatment himself. My doc previously had to quit Propecia in the past due to side effects (yeah, I know, another fear-mongerer, even though he still prescribes it) but said he’s been on 1mg oral Min for 3 months and said it’s at least seems to be holding the hair he’s with no side effects so far. To the angry boys out there; go ahead, shoot me down…but it’s just a thought. Might be worth a look?

  11. Ok sorry for the delay.
    So the aclaris news isnt groundbreaking but i found out a little today about their upcoming trial.
    I recieved an email from a research company and responded. (I get notifications from them every few months). It was regarding a new hairloss treatment thats going to be trialed.

    So i got a call back a few hours later and i asked a few questions. They were a little guarded about what they could say and basically read off the info sheet she was given.
    What i learned was:
    They are testing a hairloss treatment. It will be topical. Trial will last 30 weeks and requires 11 office visits over that time. I asked if it was once a day or twice a day. They werent sure, then i was told that it may actually be applied during the office visits only and not something i would take home with me. I was asked if i had a history of cancer or cancerous tumors. I was asked what prescriptions and supplements i take. I finally asked if they can tell me what company is running the trials. They said they arent supposed to really say, but it Is ACLARIS. Bingo! I was also told that interest is high in the study and they have a lot of people wanting to participate. They are also looking for ppl who are a Norwood 3, 4, and 5.

    So as of now im prescreened and have an appt at the end of the month. I may not have enough loss to actually participate and also I don’t live in the city where they’re holding the trial so it might be a pain for me to get back and forth 11 times. Im going to try to at least go to the first appt and see what i can learn. So it looks like the trial hasnt officially started but they are ramping up and getting participants. I would say it will begin in a month maybe. And they must believe they have their formula perfected if they are ready to go with trials.
    I don’t want to give too much away about this testing location because they divulged more than they probably should but if you need me to verify anything admin please email me. That’s all I really have for now hopefully I’ll have more at the end of the month if I decide to go along with this.

  12. Good info.

    I would fly to Japan 11 times for a cure if that’s what it took.

    Follow all their rules both in writing and verbal. Very interesting that they are trying it on people who have lost almost all of their hair. That’s very interesting.

    Sounds like it will start first or second week in May.

    Nasa_rs

  13. They just posted our Aclaris trial:
    https://clinicaltrials.gov/ct2/show/NCT03495817?term=Aclaris&rank=5

    Title: An Open-Label Safety, Tolerability, and Efficacy Study in Male and Female Subjects With Androgenetic Alopecia Treated With ATI-50002 Topical Solution
    Started: March 22, 2018 (< first participant enrolled)
    Finishes: October 30, 2018
    Timeframe: 26 weeks
    (still recruiting: Denver, Portland, & Austin)

    Champpy — does this sound like the trial you called about?
    Nasa_rs — Here we go, fingers crossed!

  14. Hey guys – re: Oral Minoxidil, I posted a comment in October last year on the previous story here that covered this topic.
    https://www.hairlosscure2020.com/oral-minoxidil-to-treat-hair-loss/

    At the time I think I was a bit late posting after the commenting had already died out, but I gave a bunch of links to the research on low dose oral Minoxidil (1mg) plus the thoughts of my own dermatologist. I would be really interested to hear other people’s thoughts…..???

    It’s easy for us armchair professors to say that we know better and use our own flimsy logic or calculations to dismiss the idea. And also easy to dismiss something that can be dangerous in higher doses. But don’t forget that many many things we eat, drink and are treated with medically are killers at higher doses but safe and even beneficial at low enough doses. Anyone drink alcohol? That will harm or even kill you at high doses of 10-40x the recommended level! Personally, clinical trial results and hard research are what I will believe. And I think the evidence is starting to build for low dose oral Minoxidil possibly being a solid improvement on topical, providing the dosage is kept low enough.

    As I said in my previous post on the above link and someone else mentioned on this new story – drug companies won’t spend money on clinical trials for something that won’t make them big profits. Research into oral minoxidil won’t make any drug companies richer because it’s an old drug. But Dr Sinclair has been plugging away for years now and his data is starting to become recognised – the hardest part is to get people to think before just dismissing it out of fear.

    I’m still going well on Fin, so not needing to try anything further yet, but I have an open mind and hope for the best re: Dr Sinclair’s research in case Replicel, etc don’t produce an accessible and effective cure any time soon. If I had lost more hair at this stage I would be taking up my dermatologists offer to add low dose minoxidil right away.

  15. Admin, can you follow up on this? Curious to see if they noticed zero side effects that minoxidil usually shows like bloating and what not.

  16. There is something very important that was not mentioned above. Minoxidil is a pre-drug the active principle is monoxide sulfate and in order to be converted into that we need that our enzyme sulfotransferase works properly. Unfortunately to know that we need a genetic test that checks our SULT1A1 gen if we think about topical conversion of minoxidil, and for the SULT1A” for the systemic version. So regarding the most absorbable version, we would say the sublingual version as it does not pass through our liver.

    1. It is minoxidil sulfate and the gene for the oral and sublingual is the SULT1A2, sorry for the errors.

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