Minoxidil 5% | Finasteride 1%

Topical scalp solution: Apply the prescribed volume (typically 1 mL) directly to clean, dry scalp in the area of hair loss once or twice daily using the dropper or pump applicator. Part the hair to maximize direct scalp contact. Gently massage into the scalp and allow to dry before lying down or applying other products. Wash hands thoroughly after each application. Do not apply to non-scalp skin, broken skin, face, or mucous membranes. Avoid washing the scalp for at least 4 hours after application to ensure adequate drug absorption.

Dosing is prescriber-determined.

• Typical regimen: 1 mL applied to the scalp once or twice daily depending on prescriber direction and patient tolerance.
• Clinical improvement (reduced shedding, early visible regrowth) generally requires 3–6 months of consistent use; maximum cosmetic benefit may take 12 months.
• An initial temporary shedding period (telogen effluvium) at 4–8 weeks is expected.
• Therapy is typically ongoing — discontinuation leads to gradual reversal of gains within 6–12 months.

• Minoxidil 5%: Opens ATP-sensitive potassium channels (KATP) in the dermal papilla cell plasma membrane, causing cell hyperpolarization and downstream activation of growth-promoting intracellular pathways. The active sulfate metabolite promotes VEGF production and anagen phase elongation. Acts independently of the androgen pathway.
• Finasteride 1%: Competitively and irreversibly inhibits type II 5α-reductase in scalp dermal papilla cells, reducing intrafollicular conversion of testosterone to dihydrotestosterone (DHT). DHT is the primary androgen mediating follicular miniaturization in AGA via androgen receptor–mediated downregulation of hair-growth factors. Topical delivery at 1% provides effective local DHT suppression; published data show scalp DHT reductions comparable to oral therapy, while serum DHT suppression is substantially less than with 1 mg oral finasteride daily.

Primary indication: Male androgenetic alopecia (male-pattern baldness, Hamilton-Norwood classification grades II–V) and select cases of female-pattern hair loss where finasteride is clinically appropriate. The combination approach is supported by clinical trial data showing superior hair density outcomes for the combination vs. either monotherapy. One published randomized controlled trial demonstrated significantly higher hair density at both 3 and 6 months for 5% minoxidil + finasteride combination vs. either ingredient alone, with comparable tolerability.

Prescriber monitoring:

• Standardized scalp photography at baseline, 6 months, and 12 months
• Serum DHT and testosterone at baseline and 3–6 months if sexual side effects are of concern
• Hepatic function in patients with liver disease (finasteride is hepatically metabolized)
• Absolute contraindication in pregnant women and women who may become pregnant — finasteride is Category X for male fetuses (external genitalia feminization)

Contraindications:

• Pregnancy and women of childbearing potential not using reliable contraception (finasteride — teratogen, Category X)
• Hypersensitivity to minoxidil or finasteride
• Pediatric patients (safety not established)

Warnings & Precautions:

• Sexual side effects: decreased libido, erectile dysfunction, and ejaculatory changes have been reported with topical finasteride at lower rates than with oral formulations — counsel patients about post-finasteride syndrome concerns
• Minoxidil systemic absorption: cardiovascular effects (tachycardia, peripheral edema, hypotension) are theoretically possible with large-area or broken-skin application
• Depression: reported rarely with 5α-reductase inhibitors; monitor mental health status

Drug Interactions:

• Topical anti-hypertensives: additive hypotensive effect if significant minoxidil absorption occurs

Common Side Effects: Scalp pruritus, dryness, or flaking; initial increased shedding (weeks 4–8); facial hypertrichosis if preparation migrates to forehead skin; rare sexual side effects (libido, ejaculation changes).

Store at room temperature (15–25°C), in a light-resistant container away from heat and moisture. Do not freeze. Keep the cap tightly closed. Observe the beyond-use date assigned by Genesis Compounding. Keep out of reach of children and away from pets.

How does topical finasteride 1% compare to the oral finasteride 1 mg pill?

Topical finasteride 1% achieves effective local scalp DHT reduction with substantially less systemic DHT suppression than the 1 mg oral dose. This means the local anti-androgen effect is preserved while the systemic hormonal effects — and associated side-effect risk — are reduced, though not eliminated.

When can I expect to see results?

Shedding reduction typically occurs at 3 months; visible density improvement at 6 months; maximum cosmetic benefit at 12 months. Consistency is essential — results reverse if therapy is discontinued.

Is the initial shedding normal?

Yes. Minoxidil causes resting (telogen) hairs to be displaced by newly activated growing (anagen) hairs, producing a temporary increase in shedding at 4–8 weeks. This is a sign that the follicles are cycling, not a sign the medication is causing harm. Continue use and reassess at the 3-month mark.

Can women use this formulation?

Minoxidil 5% is FDA-approved only for men topically; women are typically treated with 2% minoxidil. More importantly, finasteride in any form is contraindicated in pregnancy and requires careful evaluation in premenopausal women. The prescriber will individualize decisions accordingly.

Is this medication FDA-approved?

Minoxidil 5% topical solution is FDA-approved for male androgenetic alopecia; oral finasteride 1 mg is FDA-approved for male AGA. This specific combination topical preparation is a prescriber-directed 503A compounded preparation and has not been evaluated by the FDA as a compounded product.