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Oral minoxidil for hair loss: does the pill work as well as the foam?

Oral minoxidil regrew hair about as well as the foam in trials, and a new pill just posted strong Phase 3 results in 536 men. What you gain, and the trade-off.

Published October 2026

Short answer

In trials the pill regrew hair about as well as scalp foam, and a new Phase 3 pill looks strong. The trade-off is extra hair growth elsewhere. The evidence is still limited. Evidence grade C (Limited). Meta-analyses of small trials comparing oral with topical minoxidil (279 people) plus mostly uncontrolled studies; downgraded for small sample and indirectness, and the large new Phase 3 results are company-announced and unpublished.

Key takeaways

  • In four trials with 279 people, the minoxidil pill and the minoxidil foam or liquid gave about the same amount of regrowth [1].
  • The main downside is extra hair growing where you don't want it. It was about twice as likely with the pill [1].
  • At 5 mg a day or less, the pill didn't change blood pressure on average, but pulse went up slightly [2].
  • A new 8.5 mg extended-release pill posted Phase 3 results in October 2026: about 29 to 36 extra hairs per cm² versus 7 on placebo, in 536 men. That is a company announcement, not yet peer reviewed.

The short version

Oral minoxidil for hair loss works about as well as the minoxidil foam or liquid you rub on your scalp. In trials, the daily tablet and the topical version gave about the same regrowth in men with male pattern hair loss [1]. If you can't be bothered applying something to your head twice a day, that's the appeal. The catch is extra hair growth on the face and body, and it's common [1].

What the studies show

Pill versus foam: a tie. Four randomised trials with 279 people found no real difference in hair density between the tablet and the topical solution [1]. In a 2024 trial of 90 men in Brazil, 5 mg a day didn't beat 5% minoxidil applied twice a day over 24 weeks [3]. The pill's one edge was the crown of the head, where photos looked better by about a quarter, though the range around that figure was wide [3].

How much hair? One analysis that compared treatments indirectly across 23 studies put 5 mg a day at roughly 30 more thick hairs per square centimetre than the topical versions after 24 weeks, and about 10 more than 1 mg of finasteride [4]. Treat that with care: indirect comparisons are weaker, and the head-to-head trials above don't show a gap. A review of 27 studies with 2,933 people found about one in three had a clear improvement, and the benefit looked stronger above 1 mg a day [5].

The new pill. Veradermics is developing VDPHL01, an 8.5 mg extended-release minoxidil tablet. On 19 October 2026 the company announced results from Study 304, a Phase 3 placebo-controlled trial in 536 men. After six months, men on the pill had gained about 29 extra hairs per cm² on one tablet a day and 36 on two, against 7 on placebo. More than half said their hair looked better (56% and 69%, versus 15% on placebo). The company reported no treatment-related serious side effects and no heart events of concern. An earlier trial, Study 302, found similar results in 519 men. Keep in mind that these are company announcements, not a published paper, and cover six months of a 52-week study. The registry entries are NCT06972264 and NCT06724614.

The nuances

  • Extra hair growth is the big one. It was twice as likely with the pill as with the topical version [1]. In the Brazil trial, 22 of 45 men on the pill (49%) grew extra hair, and 6 of 45 (14%) got headaches [3]. Extra hair growth was behind about a third of the people who stopped treatment in one pooled analysis [2].
  • Blood pressure and heart. Minoxidil started life as a blood pressure drug. At 5 mg a day or less, blood pressure didn't change on average, pulse rose by about 3 beats per minute, and 5% of people reported symptoms of low blood pressure [2]. Most of those studies had no control group [2].
  • Dose. The published studies used 0.25 mg to 5 mg a day [6]. The new pill is 8.5 mg, so those results don't carry over automatically.
  • Who was studied. Mostly men with male pattern hair loss. The new Phase 3 trials excluded men with uncontrolled blood pressure and certain heart conditions, according to the trial registry. A trial in women is still running (NCT07146022).

What this means for you

For men with thinning hair, the pill is a real option that trials support at low doses, and it matches the foam without the daily application. The extended-release pill from the new trials is still experimental and not approved. Because minoxidil acts on blood vessels, anyone with heart disease or low blood pressure, and anyone pregnant or breastfeeding, should talk to a doctor first. The Minoxidil page has the full details.

Go deeper

  • Minoxidil — Low-dose oral minoxidil regrows hair in men with male pattern hair loss about as well as the foam or liquid used on the scalp.

References

  1. Efficacy and safety of oral minoxidil versus topical solution in androgenetic alopecia: a meta-analysis of randomized clinical trials.. Int J Dermatol, 2025.
  2. Low-dose oral minoxidil does not significantly affect blood pressure: A systematic review and meta-analysis.. J Am Acad Dermatol, 2025.
  3. Oral Minoxidil vs Topical Minoxidil for Male Androgenetic Alopecia: A Randomized Clinical Trial.. JAMA Dermatol, 2024.
  4. Relative Efficacy of Minoxidil and the 5-α Reductase Inhibitors in Androgenetic Alopecia Treatment of Male Patients: A Network Meta-analysis.. JAMA Dermatol, 2022.
  5. Efficacy and safety of oral minoxidil in the treatment of alopecia: a single-arm rate meta-analysis and systematic review.. Front Pharmacol, 2025.
  6. Low-dose oral minoxidil as treatment for non-scarring alopecia: a systematic review.. Int J Dermatol, 2020.