Satoshi Kikuchi1, Yuji Fujita1,2, Makoto Onodera1, Yasuhisa Fujino1, Yoshihiro Inoue1. 1. Department of Emergency Medicine Iwate Medical University School of Medicine Morioka Iwate Japan. 2. Poisoning and Drug Laboratory Division, Critical Care and Emergency Center Iwate Medical University Hospital Morioka Iwate Japan.
Abstract
Case: A 47-year-old man ingested 60 mL of a topical solution (3,000 mg minoxidil) and presented with prolonged hypotension. Treatment with dopamine hydrochloride and noradrenaline provided blood pressure control. Serum unchanged minoxidil concentrations at 4 and 16 h after ingestion were 4,994 and 33.9 ng/mL, respectively. Urine concentrations of unchanged minoxidil, minoxidil-O-glucuronide, and minoxidil-N-O-sulfate at 16 h after ingestion were 360.4, 1,953, and 104.5 ng/mL, respectively. Outcome: The serum unchanged minoxidil concentration rapidly decreased over a short interval. However, the patient needed to receive vasopressor support for the first 4 days after being admitted to the hospital. The urine minoxidil-O-glucuronide concentration was higher than the concentrations of unchanged minoxidil and minoxidil-N-O-sulfate. Conclusion: Although the serum concentration of unchanged minoxidil rapidly decreased, ingesting large amounts of a topical minoxidil solution can have serious and prolonged cardiovascular effects. Analyzing the minoxidil-O-glucuronide concentration in urine is useful for diagnosing minoxidil poisoning.
Case: A 47-year-old man ingested 60 mL of a topical solution (3,000 mg minoxidil) and presented with prolonged hypotension. Treatment with dopamine hydrochloride and noradrenaline provided blood pressure control. Serum unchanged minoxidil concentrations at 4 and 16 h after ingestion were 4,994 and 33.9 ng/mL, respectively. Urine concentrations of unchanged minoxidil, minoxidil-O-glucuronide, and minoxidil-N-O-sulfate at 16 h after ingestion were 360.4, 1,953, and 104.5 ng/mL, respectively. Outcome: The serum unchanged minoxidil concentration rapidly decreased over a short interval. However, the patient needed to receive vasopressor support for the first 4 days after being admitted to the hospital. The urine minoxidil-O-glucuronide concentration was higher than the concentrations of unchanged minoxidil and minoxidil-N-O-sulfate. Conclusion: Although the serum concentration of unchanged minoxidil rapidly decreased, ingesting large amounts of a topical minoxidil solution can have serious and prolonged cardiovascular effects. Analyzing the minoxidil-O-glucuronide concentration in urine is useful for diagnosing minoxidilpoisoning.
Authors: M H Adams; W J Poynor; W R Garnett; H T Karnes; J J Ferry; K K Ryan; M A Sarkar Journal: Biopharm Drug Dispos Date: 1998-11 Impact factor: 1.627
Authors: Daniela Fukushiro-Lopes; Alexandra D Hegel; Angela Russo; Vitalyi Senyuk; Margaret Liotta; Gyda C Beeson; Craig C Beeson; Joanna Burdette; Ronald K Potkul; Saverio Gentile Journal: Front Pharmacol Date: 2020-05-08 Impact factor: 5.810