Some of our favorite pharmaceuticals have been happy accidents. The first good boner pills were failed heart medications. The toxin some of us inject into our wrinkles to look younger was developed to treat eye muscle disorders.
And an extraordinarily popular drug for a good scalp massage to resurrect hair from the dead? Once upon a time, it was a breakthrough in blood pressure treatment.
Today’s Moment of Science… The many faces of Minoxidil.
When a drug flows through the body, it doesn’t take the most direct route possible from mouth to herpes sore. It’s going wherever it damn well pleases along the way. These extra tidbits of mayhem it causes throughout the rest of the body are collectively viewed as side effects.
At least they are at first. Once in a while though, the side trip becomes the real adventure.
Now, to say it’s a complicated task to create an effective heart medication would be putting it mildly. Bit of an oversimplification, but for a variety of reasons blood vessels naturally expand and contract- vasodilation and vasoconstriction, respectively. Whether it’s due to diet, medication, or just plain fucky genetics, a bit too much of that vasoconstriction over a long period of time can spell a diagnosis of high blood pressure.
There are a lot of ways to manage this, including physical activity and changes to diet. But lifestyle changes take a bit of time to work their magic, and cases of high blood pressure can be fatal. Medication to manage hypertension became available in the 1940s. Though they did help some people, they varied between toxic, ineffective, and depression inducing.
(Shit like non-linear dose responses and properly combining medications took a long time and a depressingly high number of early heart attacks to sort out, y’all- the good old days were capital F Fucked).
So, Upjohn and DAMN-O.
A pharmaceutical company founded in 1886, Upjohn (now a part of Pfizer) had a solid reputation that it wasn’t about to sully by making bald-today-hair-tomorrow pills. But it had this drug, abbreviated DAM, that failed to do what they wanted in their first trial, but showed a bit of promise in reducing blood pressure in lab animals. When no such results appeared in humans, they tortured the molecule until its chemical cousin DAMN-O was birthed. In trials, it did work on blood pressure, but there was a little issue of such severe salt and water retention that some people in the trial suffered heart failure.
They worked through hundreds of metabolites, landing on just ten to continue researching based on their potential in animal tests. But they still all had some issues with salt and water retention. It could also cause a rapid heartbeat.
The compound named minoxidil showed the most promise. Testing proceeded with caution on patients with the most severe cases, typically those that hadn’t responded to other medications. They also added beta blockers to manage heart rate and diuretics for fluid retention.
Godfuckingdamnit, the stuff worked.
The medication was approved for emergency use in 1970; patients typically had to ‘fail’ standard blood pressure medications and be dealing with organ damage to land a minoxidil script. It was initially limited to two weeks at a time. In 1971, it was approved for wider use, and started being prescribed for longer periods.
At which point, something rather hairy happened.
Patients were hit with hypertrichosis, i.e. they grew a bit of a winter coat all over. Further research showed that a topical formulation could cause that same effect of hair growth, but it could be localized.
And lo, in 1988 Upjohn entered the miracle baldness cure market with a 2% solution of minoxidil under the brand name Rogaine. But it was better than a miracle, it was motherfucking science. There are a bunch of theories on why it works, but the exact mechanism still hasn’t quite been pinned down.
New and improved blood pressure medications have been developed since the 1960s. Though it’s still sometimes used for blood pressure management, oral minoxidil has found new life in the hair growth market. The effective dose can be as low as 0.25mg and ranges up to 5mg. On the other hand, the dose for blood pressure can go as high as 100mg in a day (which sounds like it should come with complimentary laser hair removal). Both oral and topical formulations for hair loss can cause serious side effects, so please talk to your doctor before downing a medical grade vasodilator for vanity’s sake.
This has been your Moment of Science, just throwing it out there that minoxidil and viagra are both vasodilators.
Join the discussion!