Hair-loss medicine review to take to your prescriber while on Zepbound

Your shedding so far

Medicines you use or are considering

• Minoxidil 5% foam or solution on the scalp
• Oral minoxidil (prescription; off-label for hair)
• Spironolactone (prescription; off-label for hair)
• Finasteride 1 mg (men only)
• Iron, zinc, biotin or vitamin D supplements
• Blood pressure medicines, ACE inhibitors or ARBs, or potassium supplements

What each label says

• Rogaine minoxidil 5%: not for anyone under 18, and not for hair loss that is sudden or patchy or has no known cause.[1]
• Minoxidil on the scalp: stop and ask a doctor for chest pain, a racing heart, faintness, dizziness, sudden weight gain, or swollen hands or feet.[1]
• Finasteride (Propecia) must not be used by women who are or may become pregnant, and they should not handle crushed or broken tablets.[2]
• Spironolactone (Aldactone) can raise potassium: its label asks for a potassium check within 1 week of starting or changing the dose, with higher risk alongside ACE inhibitors, ARBs or potassium supplements.[3]
• Zepbound's label links its hair loss to weight reduction; in the weight trials no one on Zepbound stopped treatment because of it.[4]

Month-by-month check

Questions for the visit

1. Is this shedding from weight loss, pattern hair loss, or both?
2. Which of these medicines suits me, given my blood pressure, kidneys and pregnancy plans?
3. If oral minoxidil or spironolactone is suggested, which checks do you want and how often?
4. How many months should we give a medicine before judging it?
5. At what point would you refer me to a dermatologist?