Xandrox 12.5% Solution

Q. What is Xandrox® 12.5% Lotion? 
A. Xandrox® 12.5% Lotion is an exclusive formulation by Regrowth of topical 12.5% minoxidil and 5% azelaic acid with an absorption enhancer. It has been formulated for the treatment of MPB, and is trade marked.

Q. If 5% Xandrox® is effective in treating MPB, why produce a Xandrox 12.5% Lotion®? 
A. The stimulus effect of minoxidil on hair follicles is dose dependent. Xandrox® 12.5% Lotion has been successful in halting and/or reversing MPB in cases where other therapeutic measures have not worked well. There appears to be a threshold level at which some hair follicles will become responsive to minoxidil in regenerating terminal hairs.

Q. Why isn't Xandrox® 12.5% a solution? 
A. Although it is possible to formulate a Xandrox® 12.5% solution, some patients find a lotion easier to apply than a liquid, especially on large balding areas. A lotion does not run, whereas a liquid can.  Xandrox® 12.5% is an opaque, white, smooth lotion.

Q. If Xandrox® 12.5% is an opaque white lotion, won’t it leave a visible residue on the scalp? 
A. Using one's fingertips and with minimum massaging, the lotion disappears almost immediately into the scalp. There is almost no visible residual on the skin or hair. This is due to one of our more valuable trade secrets in its formulation. The lotion changes its physical properties so absorption and penetration occur when activated by normal body heat.

Q. On the Xandrox® 12.5% bottle label it says that the bottles should be refrigerated. What happens if it takes a while for the product to arrive from the shipping facility in Los Angeles, or if I go on a month's vacation where there isn't an available refrigerator? 
A. It shouldn’t be a problem. Xandrox® 12.5% lotion is best kept refrigerated, under which conditions it has a shelf life of at least 24 months. At room temperatures between 59 to 86 degrees Fahrenheit (15 to 30 degrees Centigrade), Xandrox® 12.5% lotion can be kept for six to eight months or more without deterioration or loss of efficacy.

Q. I live in a warm climate where Xandrox® 12.5% lotion may be subjected to heated delivery vehicles or storage facilities for extended periods of time.  Does this affect the potency of the drug? 
A. No. But it surely can affect the appearance of the lotion. When the lotion leaves Los Angeles, California, it has a smooth, creamy consistency.  As it travels over hot desert areas or remains in heated delivery vehicles and warehouses, it may change consistency or separate into layers.  If you live in a warm climate, don’t order the Xandrox® 12.5% lotion.  Instead, order the Xandrox® 15% solution, which is more effective, and costs slightly less.

Q. Why didn't you simplify this whole process and just make a high concentration gel or cream, which wouldn’t be heat sensitive? 
A. This is the compounding method used by some pharmacists. However, such compounds don’t allow for the type of liquefaction necessary for absorption. The concentration of the minoxidil in the suspending agent is important, but if proper absorption does not take place, the minoxidil is ineffectual.

Q. How about others who try to duplicate the ingredients in your formulae. Will these products work for me like Xandrox® solutions and 12.5% Xandrox® Lotion?
A. There are many trade secrets associated with the proper compounding of Xandrox® solutions and 12.5% Xandrox® Lotion. These techniques are protected by applications for patents, which have been filed. The name ‘Xandrox®’ has also been registered and trade marked to protect against generic formulae, which claim to be Xandrox®.

Q. What is the absorption enhancer used in the Xandrox® 12.5% Lotion? 
A. Benzyl nicotinate. It is chemically related to niacin and can cause a temporary ‘flushing’ of the scalp where it is applied.

Q. Why isn't benzyl nicotinamide used in the 5% Xandrox® solution? 
A. The 5% Xandrox® solution does not need an absorption enhancer because it has an alcohol base. With standard compounding techniques, minoxidil in a 12.5% concentration is not feasible with a base that is primarily alcohol. Therefore an absorption enhancer was incorporated into the Xandrox® 12.5% Lotion formula to make the absorption rates equivalent to liquid formulas with similar concentrations.

Q. If you put benzyl nicotinate into any high concentration minoxidil gel or lotion, wouldn't the resulting gel or lotion absorb like the Xandrox® 12.5% lotion? 
A. Not necessarily. The minoxidil suspended in any gel or lotion may not get released to the scalp, as it does in the Xandrox 12.5% Lotion®.

Q. Has Xandrox® 12.5% been tested? 
A. Extensively. It required more than a year just to produce the body temperature-activated type of lotion that met the criteria of effectiveness, safety and cosmetics.

Q. What have been the results of clinical trials with Xandrox 12.5% Lotion®? 
A. Although many San Diego area patients were test subjects for over a year, we do not consider this to be an adequate clinical sampling to qualify for conclusive data regarding end results. We do know from these limited tests that the majority of these patients regrew considerable amounts of hair in problem areas where other therapies had little or no effect. We have had many unsolicited positive reports via e-mail and chat groups, which validate what the San Diego test group found to be true, i.e., that minoxidils’ effectiveness is, indeed, dose dependant, and that the combination of azelaic acid with targeted doses of 12.5% micronized minoxidil lotion is the key to regrowth in areas like the frontal hairline and/or temples where other therapies had little or no effect.

Q. You indicate that the minoxidil used in Xandrox 12.5% Lotion® is micronized. What does this mean, and why is it done? 
A. The natural form of minoxidil crystals that are used in formulating 2% - 5% minoxidil solutions are white, coarse and hard, similar to table salt. Costly precision equipment at Regrowth's compounding lab is used to pulverize these crystals so they are less than 25 micron in size (similar to talcum powder).  Micronization results in improved dissolution, and in a smooth lotion, which, because it is heat activated, is better, absorbed as evidenced by an almost total lack of residue where it is applied.

Q. How much Xandrox 12.5% Lotion® should be used with each application? 
A. 1 mL, applied in a very thin layer. We suggest that no more than 2 mL of Xandrox 12.5% Lotion® be used per day. The 30 mL bottles of Xandrox 12.5% Lotion® have treatment pumps that dispense ~0.25 mL of lotion with each complete depression of the pump. The 125 mL bottles of Xandrox 12.5% Lotion® dispense ~1.0 mL with each full depression of the pumping spout.

Q. The pump on my Xandrox 12.5% Lotion® bottle doesn't work. Will you send me new pumps? 
A. The pumps must be primed in order to function correctly. If priming them in the bottle takes too long, prime them in water, and then affix them to the bottle. The first depression of the pump will produce water, but thereafter lotion will be dispensed. If proper priming does not work, your lotion has almost certainly been subjected to excessive heat.

Q.  If my Xandrox 12.5% Lotion® has been subjected to excessive heat, can I send it back for a refund?
A.  No.  The FDA does not allow patients to return prescription drugs.  Again, if you feel it’s possible that the Xandrox 12.5% Lotion® may be subjected to excessive heat, do not order it.  Instead, order Xandrox 15 or Xandrox 15+ solution.  High concentration Xandrox or minoxidil Solutions are not impacted by excessive heat.

Q. Where should Xandrox 12.5% Lotion® be used? 
A. On those areas of the scalp that are refractory to treatment of MPB by any other means. For most patients, this means the areas of both temples and/or the frontal hairline. But some patients will want or need to use it in the vertex and/or on the crown. It should not take the place of 5% Xandrox® for general application on other parts of the scalp.

Q. Do I use it in addition to 5% Xandrox®? 
A. Optimally, yes. The Xandrox 12.5% Lotion® is meant to be used as a supplement and not a replacement for the use of 5% Xandrox®. The Xandrox 12.5% Lotion® should be used in areas unresponsive or poorly responsive to 5% Xandrox® solutions.

Q. Can I overdose or have systemic effects from using such high concentrations of minoxidil? 
A. For essentially all patients, there is not sufficient absorption of minoxidil into the blood stream to cause systemic symptoms. In fact, allowing for the average amount of absorption (1.4%), the safety margin is almost ten-fold, using topical 12.5% minoxidil. However, there will be those few patients who will be hypersensitive to minoxidil or have an idiosyncratic reaction to Xandrox 12.5% Lotion®.  That percentage of patients is less than 0.1%, and they should not use high concentration minoxidil compounds.

Q. What should I do if I experience an idiosyncratic reaction to Xandrox 12.5% Lotion®? 
A. Stop using it immediately and contact Regrowth at RichardLeeMD@Xandrox.net.

Q. Is there any way to screen for patients who are hypersensitive to Xandrox 12.5% Lotion®?
A. Unfortunately, no. By definition, an idiosyncratic reaction is uncommon and peculiar to the specific patient. Several thousand patients would have to be monitored to find a similar reaction.

Q. At what time of the day should I apply the Xandrox 12.5% Lotion®? 
A. At any time of the 24-hour cycle when it can best be left undisturbed on the scalp for the longest period of time. Since the lotion becomes virtually invisible within minutes of application, it can be applied at any time of day without unflattering results. As a matter of convenience, most patients apply it at night, shortly after applying the Xandrox® 5% solution.

Q. How long should I wait until I know if Xandrox 12.5% Lotion® is working for me? 
A. Since the Xandrox 12.5% Lotion® is recruiting previously unresponsive hair follicles to grow again; these hairs will first have to be shed. The follicle will remain inactive during the ~100 days of telogen, and will then grow back thick enough so that you can appreciate the difference. This process usually takes a minimum of 4 to 6 months.

Q. Can the increased concentration of minoxidil in Xandrox 12.5% Lotion® cause temporary shedding? 
A. Yes. All minoxidil formulas can cause temporary shedding, but the amount of increased shedding is usually imperceptible. Hair that is approaching the telogen phase, or is already in the telogen phase, is prompted to shed earlier than usual due to the use of minoxidil. Rarely will much more than 10% of the hair be in the telogen phase at any given time. This means that under the worst-case scenario, approximately 10% of one's hair would be shed. If this does happen, most patients will not notice the shedding.  The shedding is due to the stimulatory effect of the minoxidil and is limited only to those areas where the Xandrox 12.5% Lotion® is being applied.  The replacement hair will appear in 100 or less days and is usually thicker than the hair that was shed.

Q. Will Xandrox 12.5% Lotion® cause a telogen effluvium or a permanent hair loss? 
A. Absolutely not. The inciting cause of a telogen effluvium is always a systemic insult.  That is not to say that there haven't been patients who have experienced shedding after using minoxidil and/or azelaic acid. On a purely statistical basis, there will be and have been patients who shed a lot of hair shortly after using Xandrox 12.5% Lotion®, but there is no sound medical evidence to show a direct ‘cause and effect’. It is most likely that those patients are experiencing a genetically induced acceleration of their male pattern baldness, totally unrelated to the use of any medication. The subject of shedding is complicated, and we have posted an article on this website entitled "Information on Shedding " that addresses these topics.

Q. Are there generic versions of Xandrox 12.5% Lotion®? 
A. No. By definition, generic means identical. There are now, and will continue to be, products which try to imitate Xandrox®. However none of these products are compounded in the same manner, as is Xandrox®. It took Dr. Lee years of laboratory testing to perfect the exact process whereby Xandrox® is compounded. Xandrox 12.5% Lotion® took two years to perfect and is, and will remain, unique. There are many trade secrets, protected by pending patents, associated with the proper compounding of Xandrox® solutions and Xandrox 12.5% Lotion®.

Q. Why doesn't Xandrox 12.5% Lotion® contain retinoic acid?
A. Retinoic acid is a very powerful drug with some undesirable side effects. Some patients cannot tolerate its use or would rather not put up with the undesirable side effects. The absorption enhancer in the Xandrox 12.5%Lotion® makes the addition of retinoic acid unnecessary. Retinoic acid should only be applied at night. The absence of retinoic acid in Xandrox 12.5% Lotion® allows it to be used at any time of the day or night..

Q. If Xandrox 12.5% Lotion® is so effective, why even use 5% Xandrox®? 
A. The 5% Xandrox® solutions are sufficiently effective on most parts of the scalp for most patients. Xandrox 12.5% Lotion® should only be used on those parts of the scalp which are stubborn in responding to 5% Xandrox®.

Q. Why does the bottle of Xandrox 12.5% Lotion® seems to be only about 3/4 full?
A. The large bottle of Xandrox 12.5% Lotion® is five ounces in size. Slightly more than four ounces are put into the bottle. The uncapped bottles weigh a minimum of 130 grams.  Almost always, the bottles contain more than 130 mL of lotion. Likewise, the small 12.5% bottles are 1 1/4 ounce in size. They are filled with a minimum of 30 mL, which means that they are slightly more than 2/3 full.