Introduction
A potent direct-acting peripheral vasodilator (vasodilator agents) that reduces peripheral resistance and produces a fall in blood pressure.
Uses
Trugain Scalp Solution 2% is an antihypertensive vasodilating agent used for resistant hypertension that is symptomatic or has caused end organ damage.
For the treatment of severe hypertension and in the topical treatment (regrowth) of androgenic alopecia in males and females and stabilisation of hair loss in patients with androgenic alopecia.
Associated Conditions
Pharmacodynamics
Trugain Scalp Solution 2% is an orally effective direct acting peripheral vasodilator that reduces elevated systolic and diastolic blood pressure by decreasing peripheral vascular resistance. Trugain Scalp Solution 2% is also used topically to treat androgenetic alopecia. Microcirculatory blood flow in animals is enhanced or maintained in all systemic vascular beds. In man, forearm and renal vascular resistance decline; forearm blood flow increases while renal blood flow and glomerular filtration rate are preserved. The predominant site of minoxidil action is arterial. Venodilation does not occur with minoxidil; thus, postural hypotension is unusual with its administration. The antihypertensive activity of minoxidil is due to its sulphate metabolite, minoxidil sulfate.
Mechanism of Action
Trugain Scalp Solution 2% is thought to promote the survival of human dermal papillary cells (DPCs) or hair cells by activating both extracellular signal-regulated kinase (ERK) and Akt and by preventing cell death by increasing the ratio of BCl-2/Bax. Trugain Scalp Solution 2% may stimulate the growth of human hairs by prolonging anagen through these proliferative and anti-apoptotic effects on DPCs. Trugain Scalp Solution 2%, when used as a vasodilator, acts by opening adenosine triphosphate-sensitive potassium channels in vascular smooth muscle cells. This vasodilation may also improve the viability of hair cells or hair follicles.
Absorption
Trugain Scalp Solution 2% is at least 90% absorbed from the GI tract in experimental animals and man.
Protein Binding
Trugain Scalp Solution 2% does not bind to plasma proteins.
Half Life
4.2 hours
Toxicity
Oral LD50 in rats has ranged from 1321-3492 mg/kg; in mice, 2456-2648 mg/kg. Side effects include cardiovascular effects associated with hypotension such as sudden weight gain, rapid heart beat, faintness or dizziness.
Food Interactions
- Take with or without food. The absorption is unaffected by food.
Dosage
For the best results, Trugain Scalp Solution 2% topical solution should be allowed to remain on the scalp for about 4 hours before washing. The night-time application should be done 2-4 hours before going to bed to allow the solution to dry out. Trugain Scalp Solution 2% topical solution should not be massaged into the scalp, but applied lightly. A hair dryer should not be used to speed up the drying of the solution as it may decrease the effectiveness. Trugain Scalp Solution 2% topical solution should not be mixed with any hair oil. The drug should not be used more than two times a day, or be taken orally or applied to any other part of the body to avoid the risk of adverse effects and unwanted hair growth. More frequent use or longer application time have no effect on hair growth. In case of missing any daily applications of Trugain Scalp Solution 2% topical solution, the patient should continue with the next application.
Hands should be washed immediately if Trugain Scalp Solution 2% topical solution is applied with the fingertips. Clinical experience with Trugain Scalp Solution 2% indicates that twice-daily applications for 4 months or more may be required before there is evidence of hair growth. To arrest hair fall, Trugain Scalp Solution 2% topical solution should be used for not less than 45 days. Depending upon the severity of hair loss or type and extent of baldness, particular strength of Trugain Scalp Solution 2% topical solution may be selected.
