Severe toxicity from ingestion of a topical minoxidil preparation

A 36-year-old man ingested several products, including a topical minoxidil solution. Within two hours of the ingestion the patient was difficult to arouse, tachycardic, and hypotensive with a systolic BP of 90 mmHg. Dopamine was required for two days to maintain his BP. Swan-Ganz catheter measurements demonstrated an increased cardiac output and decreased systemic vascular resistance. The estimated amount of minoxidil ingested was 1,000 mg. The patient recovered fully and was discharged nine days after the ingestion. The severity of symptoms and the prolonged duration of toxicity are disturbing because this product is becoming increasingly more popular and available.