Minoxidil and pericardial effusion: An idiosyncratic reaction

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Abstract
Minoxidil is a new potent antihypertensive vasodilator. Although highly effective, its use is limited by the association of the drug with pericardial effusion. Possible relationships were studied in 37 patients. There were 2 significant effusions identified by echocardiography in 22 patients under active treatment. Retrospective review of 15 additional patients no longer under treatment identified 7 who had had effusion and 1 who had had transient pericarditis. Resolution of effusion accompanied withdrawal in 5 patients; rechallenge was followed by effusion in 1 patient. Episodes (91) of pericardial disease have been reported in 1869 experimental subjects (4.8%). Pericardial tamponade occurred in 21, with 8 associated deaths. There are no specific patient chracteristics that predict the likelihood of effusion. Since the reaction is both idiosyncratic and potentially fatal, it seems appropriate to continue to limit the use of minoxidil.

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