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el minoxidil t&#243;pico acorta la fase tel&#243;gena y origina la entrada prematura de los fol&#237;culos en reposo en an&#225;geno&#46; Asimismo&#44; prolonga la fase de an&#225;geno y aumenta el tama&#241;o del fol&#237;culo piloso<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#46; Por v&#237;a oral reduce la presi&#243;n sangu&#237;nea al relajar el m&#250;sculo liso vascular a trav&#233;s de la apertura de los canales sarcolemales de potasio dependientes de ATP<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#46; Se cree que el efecto del minoxidil sobre el fol&#237;culo piloso tambi&#233;n se debe a la apertura de canales de potasio por el sulfato de minoxidil&#44; pero hasta la fecha no se ha demostrado &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Debido al perfil de efectos adversos observados a dosis est&#225;ndar&#44; la utilizaci&#243;n de minoxidil oral para el tratamiento de las alopecias no es una pr&#225;ctica muy extendida&#46; Atendiendo a la evidencia disponible&#44; el minoxidil oral a dosis bajas &#40;entre 0&#44;5-2&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41; ha demostrado ser de utilidad en casos aislados de alopecia permanente por quimioterapia<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#44; efluvio telog&#233;nico cr&#243;nico<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#44; alopecia androg&#233;nica femenina &#40;FAGA&#41;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> y moniletrix<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#46; En nuestra experiencia&#44; la utilizaci&#243;n de minoxidil oral es de especial inter&#233;s en alopecia androg&#233;nica femenina y efluvio tel&#243;geno cr&#243;nico &#40;dosis de 1<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41; y en alopecia androg&#233;nica masculina &#40;dosis de 5<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41;&#46; Utilizado en monoterapia o bien asociado a la administraci&#243;n t&#243;pica de minoxidil&#44; pero con un r&#233;gimen menos intensivo &#40;por ejemplo 3 d&#237;as en semana&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En cuanto al perfil de seguridad&#44; la hipertricosis facial constituye el principal efecto adverso&#46; El riesgo es dosis dependiente &#40;4&#37; a dosis de 0&#44;25<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#44; 38&#37; a dosis de 1<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a> y es reversible con la suspensi&#243;n del tratamiento&#46; En nuestra experiencia personal es de grado leve y no supone un problema real para la paciente&#46; Adem&#225;s&#44; se han notificado casos aislados &#40;&#60;<span class="elsevierStyleHsp" style=""></span>2&#37; de pacientes&#41; de hipotensi&#243;n postural y taquicardia<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#44; por lo que se recomienda una medici&#243;n basal de la tensi&#243;n arterial y en aquellos pacientes con valores menores a 90&#47;60<span class="elsevierStyleHsp" style=""></span>mmHg o s&#237;ntomas de hipotensi&#243;n postural a&#241;adir 50<span class="elsevierStyleHsp" style=""></span>mg de cloruro s&#243;dico a la formulaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46; En nuestra pr&#225;ctica profesional&#44; dosis de 1<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a o menores son seguras y es excepcional que produzcan hipotensi&#243;n&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En Espa&#241;a&#44; el minoxidil oral est&#225; comercializado para el tratamiento de la hipertensi&#243;n arterial grave en comprimidos de 10<span class="elsevierStyleHsp" style=""></span>mg&#44; pero puede formularse en c&#225;psulas&#46; En mujeres con FAGA&#44; la adici&#243;n de espironolactona 25<span class="elsevierStyleHsp" style=""></span>mg reduce el riesgo de edemas en extremidades inferiores y potencia la terapia&#44; aunque te&#243;ricamente puede empeorar la hipotensi&#243;n postural<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; el minoxidil oral en dosis bajas constituye una alternativa terap&#233;utica de gran inter&#233;s en pacientes intolerantes o que no deseen utilizar la v&#237;a de administraci&#243;n t&#243;pica&#44; especialmente en casos de FAGA&#46;</p></span>"
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FR – Minoxidil oral para el tratamiento de la alopecia androgénica femenina y otras alopecias
RF – Oral Minoxidil for Female Pattern Hair Loss and Other Alopecias
C. Pindado-Ortega
Corresponding author
cpindadoortega@gmail.com

Autor para correspondencia.
, D. Saceda-Corralo, S. Vañó-Galván
Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, España
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#41; Mujer de 33 a&#241;os con alopecia androg&#233;nica femenina antes del inicio del tratamiento con minoxidil oral 1<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#46; B&#41; A los 12 meses de tratamiento&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">El minoxidil oral &#40;2&#44;4-diamino-6-piperidinopirimidina-3-&#243;xido&#41; se utiliz&#243; inicialmente en la d&#233;cada de los 70 como un potente vasodilatador perif&#233;rico para el tratamiento de la hipertensi&#243;n refractaria grave a dosis de 10-100<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#46; Dado que una cuarta parte de los pacientes desarroll&#243; hipertricosis&#44; se formul&#243; la presentaci&#243;n t&#243;pica para el tratamiento de la alopecia androg&#233;nica&#44; inicialmente masculina y posteriormente femenina&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El conocimiento del mecanismo de acci&#243;n del minoxidil sobre el fol&#237;culo piloso es muy limitado&#46; A trav&#233;s de su forma activa&#44; el sulfato de minoxidil&#44; el minoxidil t&#243;pico acorta la fase tel&#243;gena y origina la entrada prematura de los fol&#237;culos en reposo en an&#225;geno&#46; Asimismo&#44; prolonga la fase de an&#225;geno y aumenta el tama&#241;o del fol&#237;culo piloso<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#46; Por v&#237;a oral reduce la presi&#243;n sangu&#237;nea al relajar el m&#250;sculo liso vascular a trav&#233;s de la apertura de los canales sarcolemales de potasio dependientes de ATP<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#46; Se cree que el efecto del minoxidil sobre el fol&#237;culo piloso tambi&#233;n se debe a la apertura de canales de potasio por el sulfato de minoxidil&#44; pero hasta la fecha no se ha demostrado &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Debido al perfil de efectos adversos observados a dosis est&#225;ndar&#44; la utilizaci&#243;n de minoxidil oral para el tratamiento de las alopecias no es una pr&#225;ctica muy extendida&#46; Atendiendo a la evidencia disponible&#44; el minoxidil oral a dosis bajas &#40;entre 0&#44;5-2&#44;5<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41; ha demostrado ser de utilidad en casos aislados de alopecia permanente por quimioterapia<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#44; efluvio telog&#233;nico cr&#243;nico<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#44; alopecia androg&#233;nica femenina &#40;FAGA&#41;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> y moniletrix<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#46; En nuestra experiencia&#44; la utilizaci&#243;n de minoxidil oral es de especial inter&#233;s en alopecia androg&#233;nica femenina y efluvio tel&#243;geno cr&#243;nico &#40;dosis de 1<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41; y en alopecia androg&#233;nica masculina &#40;dosis de 5<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41;&#46; Utilizado en monoterapia o bien asociado a la administraci&#243;n t&#243;pica de minoxidil&#44; pero con un r&#233;gimen menos intensivo &#40;por ejemplo 3 d&#237;as en semana&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En cuanto al perfil de seguridad&#44; la hipertricosis facial constituye el principal efecto adverso&#46; El riesgo es dosis dependiente &#40;4&#37; a dosis de 0&#44;25<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#44; 38&#37; a dosis de 1<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a&#41;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">4&#44;5</span></a> y es reversible con la suspensi&#243;n del tratamiento&#46; En nuestra experiencia personal es de grado leve y no supone un problema real para la paciente&#46; Adem&#225;s&#44; se han notificado casos aislados &#40;&#60;<span class="elsevierStyleHsp" style=""></span>2&#37; de pacientes&#41; de hipotensi&#243;n postural y taquicardia<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#44; por lo que se recomienda una medici&#243;n basal de la tensi&#243;n arterial y en aquellos pacientes con valores menores a 90&#47;60<span class="elsevierStyleHsp" style=""></span>mmHg o s&#237;ntomas de hipotensi&#243;n postural a&#241;adir 50<span class="elsevierStyleHsp" style=""></span>mg de cloruro s&#243;dico a la formulaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46; En nuestra pr&#225;ctica profesional&#44; dosis de 1<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#237;a o menores son seguras y es excepcional que produzcan hipotensi&#243;n&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En Espa&#241;a&#44; el minoxidil oral est&#225; comercializado para el tratamiento de la hipertensi&#243;n arterial grave en comprimidos de 10<span class="elsevierStyleHsp" style=""></span>mg&#44; pero puede formularse en c&#225;psulas&#46; En mujeres con FAGA&#44; la adici&#243;n de espironolactona 25<span class="elsevierStyleHsp" style=""></span>mg reduce el riesgo de edemas en extremidades inferiores y potencia la terapia&#44; aunque te&#243;ricamente puede empeorar la hipotensi&#243;n postural<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; el minoxidil oral en dosis bajas constituye una alternativa terap&#233;utica de gran inter&#233;s en pacientes intolerantes o que no deseen utilizar la v&#237;a de administraci&#243;n t&#243;pica&#44; especialmente en casos de FAGA&#46;</p></span>"
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Article information
ISSN: 00017310
Original language: Spanish
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