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Pharmacology and teratology

Minoxidil is used orally as a systemic antihypertensive drug with vasodilatory activity. Topically, it is used in cases of androgenetic alopecia and other types of baldness. The ingredient is lipophylic, and the resorption rate is 2-3°/o. The concentrations in the serum are far below therapeutic levels in adults. In a prospective study, 17 pregnant women were treated with minoxidil. Of 15 newborns, 1 had an unspecified developmental disorder of the heart (Shapiro 2003). A case report {Smorlesi 2003) describes a woman who applied minoxidil to her scalp at least twice daily during pregnancy. Fetal pathology revealed an enlarged heart with distal stenosis of the aorta, an enlarged sigmoid colon and mesentery, and enlarged cerebral ventricles with brain hemorrhages. The placenta had numerous ischemic and indurative areas, and a discrepancy between gestational age and villi maturation. Another publication reveals a developmental sacral disorder and malformation of the lower extremities, lower vertebral aplasia, agenesis of both kidneys, and an atresic esophagus in a severely hypertrophic fetus born to a mother who had used minodil for years {Rojanski 2002).

There is no experience with eflornithin for hirsutism during pregnancy.

Recommendation. Since there are no conclusive studies, neither oral nor topical treatment with minoxidil is acceptable during pregnancy. However, inadvertent exposure does not justify either interruption of pregnancy or invasive diagnostic procedures. "Hie same holds for eflornithin.

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