Minoxidil Intoxication: A Case of Refractory Shock With Prolonged Supportive Care

Minoxidil, commonly used as a topical agent for alopecia, is occasionally used for refractory hypertension due to its antihypertensive properties. We report a rare case of massive minoxidil intoxication leading to refractory vasoplegic shock in a 24-year-old male. The patient ingested 120 mL of 5% minoxidil solution, resulting in vasoplegic shock. Management included fluid resuscitation and norepinephrine support. The patient required norepinephrine for 180 hours to maintain mean arterial pressure, a duration unprecedented in the literature. This case underscores the potential for prolonged vasopressor dependency following massive minoxidil ingestion and highlights the necessity for intensive symptomatic management. This report adds to the limited literature on minoxidil intoxication and suggests that extensive supportive care can be prolonged.