Loniten for Severe Hypertension

Loniten is an oral drug for treating severely elevated or refractory high blood pressure. Refractory hypertension does not respond to other antihypertensive medications like diuretics (water pills) and ACE inhibitors. Loniten belongs to a group of drugs referred to as vasodilators, and is approved for use in children, adults, and the elderly.  

What is Loniten, and How Does it Work?

Loniten is the brand name for oral minoxidil used to treat refractory hypertension. Minoxidil induces relaxation (vasodilation) of peripheral blood vessels, reducing resistance and allowing blood to flow more easily. This reduces blood pressure within the arteries and veins, treating hypertension. When administering Loniten, a water pill and beta-adrenergic antagonist are also given to minimize adverse effects. Because of its risk profile, Loniten is reserved for treating high blood pressure that does not respond to maximal doses of diuretics plus two other antihypertensive medications, as outlined in the guidelines.

Unlike mild to moderate hypertension, severely elevated blood pressure is usually symptomatic and causes damage to target organs such as the kidney, heart, and brain. Typically, treatment of hypertension begins with drugs such as hydrochlorothiazide and Benicar. Loniten is only indicated when these agents fail, even at the maximal dosage.

Although minoxidil can treat several other conditions, including hair loss, Loniten tablets should not be used for other purposes besides severe hypertension control.

How to Take Loniten

Before taking Loniten tablets, read the patient information leaflet or medication guidelines usually found in the drug package. If you have any questions or concerns, seek clarification from the pharmacist or doctor.

As a prescription drug, take Loniten (minoxidil) tablets according to the doctor’s instructions. Usually, the medicine is taken orally, with or without food. The frequency of dosing depends on the severity of hypertension and response to treatment. The doctor may prescribe Loniten as a single or twice-daily dosing, usually starting at the lowest recommended dosage and gradually increasing it until the desired outcome is achieved.

Follow the provider’s instructions carefully for optimum results. Do not stop or take lower than the prescribed amount, even when you begin to feel better. Only the doctor should initiate any change in Loniten dosage. It might take a few days before feeling the full benefit of ingesting Loniten tablets. However, if the symptoms do not improve or worsen, inform the doctor promptly for dose increment or drug switching.

Loniten can be used alone or in combination with other medications for hypertension. Taking the drug(s) at a particular time of the day enhances compliance and helps maintain optimum blood pressure.

Note: Sudden discontinuation of Loniten can worsen or precipitate severe reactions, necessitating dose tapering when withdrawing the drug. Do not stop using Loniten without consulting a medic. 

Loniten Dosages

Loniten tablet dosage varies depending on the age, with 12 years as the cut-off.

Patients above 12 years

The recommended starting dose of Loniten is 5 mg of minoxidil, taken as a single dose or in two divided doses. Sometimes the initial dose does not lower the blood pressure to the desired level. In such instances, the doctor might increase the daily dose to 10 mg, 20 mg, or 40 mg as appropriate. Dosage adjustments should be made after at least three days, the duration it takes for the full response with a particular dose to be achieved. The maximum recommended daily dose is 100 mg of minoxidil.

Whether the drug is administered as a single dose or in divided doses depends on the diastolic blood pressure recorded in a day. For instance, if diastolic blood pressure reduces by less than 30 mmHg, single dosing is indicated.

Patients under 12 years

Minoxidil dosage for children below 12 years is based on weight. Initially, Loniten is administered at the rate of 0.2 mg/kg. The dose can be increased by 50 or 100 percent until the optimum blood pressure is obtained. The maximum recommended dose for children is 50 mg per day.

What Are the Possible Side Effects of Loniten?

Like any medication, Loniten can bring about unwanted effects even at therapeutic doses. The most common side effects include;

• Nausea and vomiting
• Breast tenderness or pain
• Rash
• Facial or body hair changes, including color, coarseness, or length

Loniten may also cause severe effects that warrant contacting the emergency department or the doctor as they occur. These include;

• Signs of allergic reaction such as hives, breathing difficulties, and swelling of the body, face, tongue, or lips
• New-onset or worsening chest pain radiating to the left shoulder or jaw
• Fast and loud heartbeats
• Lower limb swelling
• Rapid weight gain, more around the midsection and the face
• Lightheadedness, a feeling that one might pass out
• Signs and symptoms of fluid build-up in the lungs such as painful breathing, breathlessness on lying down, wheezing, and productive with foamy sputum
• Severe skin reaction characterized by facial swelling, fever, and burning sensation in the eyes, and fever followed by a skin rash with blistering and peeling.

Drug Interactions and Contraindications

More than 160 drugs are known to interact with Loniten. The interactions can be major, moderate, or minor. For instance, guanethidine can interact with Loniten to cause orthostatic hypotension and is therefore classified as a major interaction. NSAIDS and cough medications can also interact with Loniten (minoxidil) tablets.

Drug interactions alter how Loniten works and might reduce its effectiveness or cause toxicity. Before starting the medication, a subject needs to inform the doctor or pharmacist of all prescribed, over-the-counter and herbal medicines they are currently using. Keeping a list of the current medications ensures one does not forget any drug and eliminates the risk of interaction, especially in the case of polypharmacy.

Loniten is contraindicated in:

• Individuals who are allergic to minoxidil or any other inactive ingredient of the drug.
• Those with pheochromocytoma, as the antihypertensive activity of Loniten, can stimulate catecholamine secretion from the tumor.

Are There Any Special Precautions to Observe When Using Loniten?

Minoxidil, the active ingredient of Loniten, is a potent antihypertensive agent that can also produce severe adverse effects. The drug can induce or exacerbate serious conditions such as:

• Pericardial effusion
• Myocardial lesions
• Angina pectoris and
• Cardiac tamponade

Strictly, Loniten should be used for patients with elevated blood pressure unresponsive to the maximum therapeutic doses of at least three first-line antihypertensive drugs, owing to its adverse effect profile.

Administration of Loniten requires close supervision and concomitant ingestion of a beta-blocker and a loop diuretic. The beta-blocking drug helps prevent increased heart rate and myocardial workload that Loniten can precipitate, while the diuretic averts fluid accumulation and possible congestive heart failure. Diuretics acting on the ascending loop of Henle are more effective than other water pills.

When administering Loniten to subjects with malignant hypertension or already taking guanethidine, hospitalization is necessary for monitoring and preventing rapid pressure decline effectively, leading to hypotension.

Alternative Medicines for Elevated Blood Pressure

Other medicines for treating high blood pressure include;

• Diuretics like hydrochlorothiazide
• Beta-blockers like propranolol
• ACE inhibitors such as Prinivil and Altace
• Angiotensin II receptor blockers like olmesartan
• Calcium channel blockers, including nicardipine
• Central agonists such as Aldomet and Catapres

How to Order Loniten Online

Kiwi Drug offers affordable access to all medications for everyone across the globe. Subject to industry regulations, Kiwi uses professional pharmacists to ensure the clients receive the best services and maintain optimum quality of life. You need to have a doctor’s prescription when purchasing Loniten, however Kiwi's online doctor may issue you one via the online doctor service from Kiwi Drug, subject to review of your medical profile. The process is straightforward and quick:

• Add the product to the cart
• Click on Checkout Now
• Answer the questions presented on the next page
• Enter payment details and wait for your order to arrive