Minoxidil / Tretinoin / Progesterone / Finasteride – Solution

Available Dosage Strengths

5% / 0.025% / 0.25% / 0.1%

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Minoxidil Tretinoin Progesterone Finasteride Solution

Product Overview

Description

This formulation includes minoxidil, tretinoin, progesterone, and finasteride to address hormonal hair loss. Each drug has a unique mechanism of action to support development and growth of hair. The synergistic blend promotes fuller, stronger hair while supporting long-term scalp and follicle vitality.

Minoxidil ^1-3

Topical minoxidil is a vasodilatory compound originally developed as an oral antihypertensive agent. It was found to stimulate hair growth (from the observation of hypertrichosis (excessive, abnormal hair growth) in patients taking oral minoxidil) and was subsequently FDA approved for androgenetic alopecia (male and female pattern hair loss).³

Tretinoin^4-7

Tretinoin, a naturally occurring derivative of vitamin A, is also called all-trans-retinoic acid. Retinoids may facilitate regulation of cell reproduction, cell proliferation and differentiation. Combining tretinoin and minoxidil may provide a synergistic increase in the expression of hair growth markers (e.g., Erk, Akt, Bcl-2, and Bax).

Progesterone^8-10

Micronized progesterone is a bioidentical form of the naturally occurring hormone progesterone that is used for women’s health, including hormone replacement therapy (HRT)and prevention of endometrial hyperplasia in postmenopausal women receiving estrogen therapy. Progresterone may have benefits to facilitate or maintaining hair growth.

Finasteride Description^11-14

Finasteride, a 5-alpha reductase inhibitor, has been shown to benefit patients with female pattern hair loss.  Finasteride topically has shown to improve hair density and hair growth in pre-menopausal and post-menopausal women.

Mechanism of Action

Minoxidil^1-3

The drug has many mechanisms in supporting hair growth:

Potassium channel opening: Minoxidil is a K⁺-ATP channel opener, which may result in vasodilation and enhanced blood flow to hair follicles.
Prolongation of the hair cycle: It may extend the growth phase of the hair cycle, leading to increased follicle size and more robust hair shafts.
Activation of prostaglandins: May indirectly affect prostaglandin-mediated signaling to stimulate hair follicle activity.
Upregulation of vascular endothelial growth factor (VEGF): Promotes angiogenesis in dermal papillae, which may improve follicular nourishment.

Tretinoin^4-7

Tretinoin may have several mechanisms to facilitate hair growth including the following:

Cell turnover-Tretinoin facilitates skin cell turnover which may open up hair follicles for hair growth
Enhanced absorption-Tretinoin may help absorption of minoxidil. This may be from the increased absorption of minoxidil which may be the result of increased sulfonation.
Prolong anagen phase-Tretinoin may help lengthen the growth phase of hair follicles.

Progesterone^8-10

Progesterone is a steroid hormone primarily secreted by the corpus luteum and, during pregnancy, the placenta, it binds PR-A & PR-B receptors and the primary actions in women include:
- Endometrial transformation: Converts the endometrium from a proliferative to a secretory state, supporting implantation and pregnancy.
- Regulation of gonadotropin secretion: Via negative feedback on the hypothalamic-pituitary axis.
- Stabilization of the endometrium helps to prevent irregular bleeding in women receiving estrogen therapy.
- CNS effects: Modulates mood, sleep, and neuroprotective pathways through GABA-A receptor modulation.

It can also influence hair growth by inhibiting LH secretion which can decrease androgen synthesis and decrease the conversion of testosterone to dihydrotestosterone through the inhibition of 5-alpha reductase activity.

Finasteride^11-14

Finasteride is an analog of testosterone that acts as a competitive, specific inhibitor of type II 5-alpha-reductase, an intracellular enzyme that converts testosterone to the potent androgen 5-alpha-dihydrotestosterone. The type II 5-alpha-reductase isozyme is found in the scalp hair follicles. Finasteride may decrease dihydrotestosterone levels through its effect on increasing insulin growth factor-1 production in the dermal papillae.

Adverse Reactions

Minoxidil^1-3

Common

Topical minoxidil is generally well tolerated but may cause local effects including the following:

Scalp irritation, dryness, flaking
Erythema or contact dermatitis (more common with propylene glycol-containing formulations)
Pruritus or burning sensation
Unwanted facial hair growth (esp. in women or if solution drips onto other areas)

Tretinoin^4-7

Common

Skin irritation, such as peeling, xerosis (dry skin), burning, stinging, erythema, and pruritus

Progesterone^8-10

Common (with systemic absorption) (topical application is not expected to be absorbed significantly systemically)

Drowsiness or sedation
Breast tenderness
Headache
Bloating
Mood changes
Irregular bleeding or spotting
Dizziness

Finasteride^11-14

Common

Scalp pruritus, burning sensation, irritation, contact dermatitis, and erythema

With systemic absorption (rare)

Decreased libido
Erectile dysfunction
Ejaculatory disorders (e.g., reduced volume)
Breast tenderness or enlargement
Gynecomastia

Contraindications & Precautions

Contraindications^1,2,4,8,11

Known hypersensitivity or intolerance to minoxidil, tretinoin, progesterone, and finasteride or excipients
Contraindicated in women who are or may become pregnant if absorbed systemically due to risk of teratogenicity (can cause abnormalities in the external genitalia of male fetuses)
Undiagnosed abnormal menstrual bleeding (systemic absorption of progesterone)
Known, suspected, or history of breast cancer(systemic absorption of progesterone)
Active or history of thromboembolic disorders (stroke, DVT, heart attack etc…) (systemic absorption of progesterone)
Liver dysfunction or disease (systemic absorption of progesterone)

Precautions^1,2,4,8,11

Do not apply to open wounds
Finasteride lowers serum PSA levels by ~50% after 6 months, which can mask early detection of prostate cancer
Use cautiously in patients with hepatic dysfunction. The drug is metabolized extensively in the liver

Storage

Store at controlled room temperature, between 68°F to 77°F (20°C to 25°C). Protect from light and keep the container tightly closed. Women should not handle crushed or broken finasteride tablets when they are pregnant or may potentially be pregnant because of the possibility of absorption of finasteride and the subsequent potential risk to a male fetus. Keep out of reach of children and pets.

References

Clinical Pharmacology [Internet].: Elsevier; accessed May 2025; Minoxidil topical monograph. Available from: ClinicalKey; https://www.clinicalkey.com/pharmacology/monograph/408?n=Minoxidil
Rogaine® (minoxidil topical solution) package insert. Johnson & Johnson Consumer Inc.https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=12fd18f0-859c-7b9a-e063-6394a90addbf&type=display Revised March 2024. Accessed June 16, 2025
Goren A, Naccarato T. Minoxidil in the treatment of androgenetic alopecia. Dermatol Ther. 2018 Sep;31(5):e12686.
Clinical Pharmacology tretinoin clinical monograph 2025 https://www.clinicalkey.com/pharmacology/
Yoham AL, Casadesus D. Tretinoin. Statpearls. March 27, 2023. Accessed July 27, 2025.
Sharma A, Goren A, Dhurat R, Agrawal S, Sinclair R, Trüeb RM, Vañó-Galván S, Chen G, Tan Y, Kovacevic M, Situm M, McCoy J. Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes. Dermatol Ther. 2019 May;32(3):e12915.
Can Tretinoin Help with Hair Growth? https://cityskinclinic.com/tretinoin-hair-growth/ June 12, 2025. Accessed August 15, 2025
FDA Label for Prometrium® (micronized progesterone); accessed July 2025 through: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019781s013lbl.pdf
Cynthia A. Stuenkel, Susan R. Davis, Anne Gompel, Mary Ann Lumsden, M. Hassan Murad, JoAnn V. Pinkerton, Richard J. Santen, Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 100, Issue 11, 1 November 2015, Pages 3975–4011, accessed July 2025 through: https://doi.org/10.1210/jc.2015-2236
Clinical Pharmacology Progesterone clinical monograph accessed July 2025 through: https://www.clinicalkey.com/pharmacology/monograph/515?n=Progesterone
Clinical Pharmacology finasteride clinical monograph 2025 https://www.clinicalkey.com/pharmacology/ Accessed August 15, 2025
Gupta AK, Talukder M. Topical finasteride for male and female pattern hair loss: Is it a safe and effective alternative? J Cosmet Dermatol. 2022 May;21(5):1841-1848.
Iamsumang W, Leerunyakul K, Suchonwanit P. Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date. Drug Des Devel Ther. 2020 Mar 2;14:951-959.
Finasteride (Propecia) www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf April 2012. Accessed August 15, 2025.

Disclaimer

This information is for educational purposes only. This compounded product has not been reviewed, approved, or evaluated by the Food and Drug Administration for safety and effectiveness. This product is not intended to diagnose, treat, cure, or prevent any disease. No claims are made regarding treatment, cure, or prevention of any disease or condition.

This information may not cover all possible drug information about this product. Call your doctor for medical advice and/or about side effects. You may report side effects to the FDA at 1-800-FDA-1088. A Wells Pharmacy Network pharmacist will be happy to answer any questions. For consultation, please call 1-800-622-4510.