Q. After reading about low-dose minoxidil a few years ago, I got a prescription from my general practitioner and have been taking it ever since.

My fine hair began to thin with menopause, and I could barely make a ponytail.

I estimate its quantity has increased by 30% to 40% without any apparent side effects. For the first time in years, the hairline around my face has filled in and I’m not obliged to have a short fringe. Having more hair has been a great improvement and I will continue to take 2.5 milligrams of minoxidil daily.

A. A recent systematic review of 27 studies of this off-label use of the blood pressure pill minoxidil found that 35% to 47% of participants noticed improved hair growth (Frontiers in Pharmacology, June 3, 2025).

Most side effects were minor, although some people had unwanted hair growth and a few reported swollen ankles. The dose you are taking appears to be in line with the effective dose in these studies.

Minoxidil was originally approved to treat high blood pressure in 1979.

The oral dose ranges from 5 to 100 milligrams daily.

At those doses, though, side effects can be severe.

Low-dose minoxidil (0.25 milligrams to 5 milligrams) is considered much safer but still requires medical supervision.

Q. A few years ago, my cardiologist put me on spironolactone to lower my blood pressure from 140/80.

Shortly thereafter, I got up from bed for the bathroom.

I blacked out in the bathroom, fell and fractured two vertebrae.

I was given a walker and kept on the spironolactone. Later, I was using the walker to get to the bathroom in the middle of the night. I blacked out again, fell onto the walker and cut both knees. That resulted in a three-week stay in a rehab facility.

My cardiologist never mentioned that spironolactone might make me faint or fall. I’m no longer on any blood pressure medication, but due to the fractures, I am 4 inches shorter, and my life has been changed forever.

A. A recent article in JAMA Health Forum (Aug. 1, 2025) points out that older Americans are at high risk for dying from medication-induced falls.

In fact, more people die from falls than from breast cancer, prostate cancer or car crashes.

While it is important to control high blood pressure, overtreatment that causes dizziness or blackouts can be life-threatening.

Other drugs that also put older people at risk for falls include anti-anxiety drugs (benzodiazepines), antidepressants and pain relievers, including opioids and gabapentinoids (gabapentin and pregabalin).

Anyone who feels dizzy or unsteady should ask their primary care provider to review their meds and deprescribe any that are no longer essential.

To learn more about how to lower blood pressure, you may wish to read our “eGuide to Blood Pressure Solutions.”

This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. I was prescribed omeprazole for 25 years. Out of the blue, with no other risk factors, I was diagnosed four years ago with stage 3 kidney disease.

I was treated for the kidney disease with immunosuppressant drugs and have been in remission for three years. When I mentioned that proton pump inhibitors like omeprazole have been linked to kidney problems, my nephrologist rolled his eyes. I still believe it was the cause of my condition.

A. A systematic review of proton pump inhibitors (PPIs) such as omeprazole concluded: “PPIs are associated with the development of CKD” [chronic kidney disease] (Cureus, Dec. 3, 2023).

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”