Executive Insights: Extended-Release Oral Minoxidil Shows Optimized Pharmacokinetics and Potential to Enhance Hair Growth

At the 2026 American Academy of Dermatology (AAD) Annual Meeting, emerging data on Veradermics’ investigational extended-release oral minoxidil (VDPHL01) highlighted a pharmacokinetically optimized approach to a well-established therapeutic pathway in androgenetic alopecia.¹ Reid Waldman, MD, co-founder and CEO of Veradermics, spoke with Christopher Bunick, MD, PhD, associate professor of dermatology at Yale School of Medicine and Dermatology Times’ editor in chief, to outline the scientific rationale and early clinical implications of this reformulation.

As Waldman mentioned, minoxidil is a cornerstone in hair loss management, with topical formulations FDA-approved for androgenetic alopecia and oral formulations widely used off-label. However, conventional oral minoxidil reflects its origins as an antihypertensive agent, characterized by rapid absorption, peak plasma concentrations within approximately 2 hours, and near-complete systemic clearance within 4 hours. This pharmacokinetic profile may limit sustained follicular exposure, potentially constraining therapeutic efficacy while contributing to cardiovascular adverse effects linked to peak concentrations.

“Why is the best tool in our toolkit as dermatologists a 40-year-old blood pressure medication that no one’s aimed to optimize,” Waldman said.

VDPHL01 was developed to address these limitations through an extended-release delivery system designed to maintain consistent plasma levels of minoxidil throughout the day. According to Waldman, phase 1 pharmacokinetic data demonstrate prolonged systemic exposure with attenuated peak concentrations, a profile intended to remain above the threshold required for hair growth while minimizing exposure associated with tachycardia and other cardiovascular events.

A key mechanistic consideration discussed was the role of sulfation in minoxidil activation. Minoxidil itself is a prodrug requiring conversion to minoxidil sulfate via sulfotransferase enzymes (notably SULT1A1) within the outer root sheath of the hair follicle. This enzymatic process is both capacity-limited and time-dependent. Rapid systemic spikes associated with immediate-release formulations may overwhelm enzymatic capacity while providing insufficient duration for sustained conversion to the active metabolite.

In contrast, extended-release delivery may enhance bioactivation by maintaining steady substrate availability, thereby facilitating more efficient sulfation over time. This mechanism could theoretically increase both the magnitude and consistency of clinical response across patients, addressing known interindividual variability in sulfotransferase activity.

“If you keep minoxidil at the follicle at optimal levels for a longer period of time, you have the potential to drive the formation of the true active that drives hair growth,” Waldman said.

While full clinical efficacy data are forthcoming, the pharmacologic profile of VDPHL01 suggests a differentiated therapeutic approach that aligns drug exposure more closely with follicular biology. As Bunick noted, this strategy represents a potential evolution in the use of minoxidil, transitioning from repurposed antihypertensive to a dermatology-optimized therapy designed specifically for hair follicle targeting.

Further results from ongoing clinical trials will be needed to determine whether these pharmacokinetic and mechanistic advantages translate into meaningful improvements in hair density, durability of response, and safety outcomes in patients with patterned hair loss.

Stay tuned for part 2 of the conversation.

Reference

1. Veradermics announces presentations on VDPHL01 and patient experiences with pattern hair loss at 2026 American Academy of Dermatology Annual Meeting. News release. Veradermics. March 18, 2026. Accessed March 29, 2026. https://ir.veradermics.com/news-releases/news-release-details/veradermics-announces-presentations-vdphl01-and-patient