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Minoxidil 5% / Finasteride / Latanoprost / Ketoconazole Spray
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Minoxidil 5% + Finasteride + Latanoprost + Ketoconazole Spray: Four-Active Topical for Hair Loss
A combination topical that adds latanoprost’s hair-elongating effect and ketoconazole’s anti-inflammatory action to a finasteride-minoxidil base.
This compounded topical spray combines standard 5% minoxidil with topical finasteride, latanoprost, and ketoconazole. Latanoprost is a prostaglandin analog (originally used for glaucoma) that has been observed to lengthen and thicken eyelashes and is now used off-label for scalp hair. Ketoconazole is an antifungal that also has anti-inflammatory and (in some studies) mild anti-androgen activity at the scalp. Together with minoxidil and finasteride, this formula targets growth, DHT, prostaglandin pathways, and inflammation.
Physician-prescribed · Compounded by licensed US pharmacies · Four-active formula · Ongoing care team support
Minoxidil 5%: Minoxidil is a topical vasodilator that’s been used for hair loss for decades. It improves blood flow to follicles, extends the active growth phase of the hair cycle, and can stimulate dormant follicles. It works for both men and women and is typically applied once or twice daily to areas of thinning or loss. Five percent is the most-studied concentration for both men and women.
Topical Finasteride: Finasteride blocks the enzyme 5-alpha-reductase, which converts testosterone into DHT. DHT is the hormone primarily responsible for shrinking hair follicles in pattern hair loss. Lowering DHT lets follicles recover, slowing or stopping further loss and (for many men) supporting regrowth. Topical delivery reduces systemic absorption.
Latanoprost (Prostaglandin F2-alpha Analog): Latanoprost is FDA-approved for glaucoma. A documented side effect (longer, thicker eyelashes) led to investigation for scalp hair, where small studies have shown effects on hair shaft thickness and growth.
Ketoconazole (Antifungal with Anti-inflammatory Activity): Ketoconazole shampoo has been studied for hair loss for years. The mechanism is not fully understood but includes anti-inflammatory effects on the scalp and possible mild anti-androgen activity locally.
Best for: Adults with pattern hair loss who want a multi-mechanism topical without the high-strength minoxidil concentration. Particularly appropriate for those with scalp inflammation, dandruff, or seborrheic dermatitis alongside hair loss.
Not recommended for: Pregnant or breastfeeding individuals (or anyone who may become pregnant), people with active scalp infections beyond the formula’s scope, and those allergic to any component.
Most common side effects are scalp irritation, redness, dryness, and itching. An initial shed in the first 4 to 8 weeks is normal. Less common: changes in skin pigmentation at application sites (latanoprost), and the side effects of topical finasteride.
¹ 5% minoxidil significantly increases hair regrowth versus placebo Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. Journal of the American Academy of Dermatology, 2002;47(3):377-385. → PubMed
² About 90% of men maintained or improved hair over 5 years (finasteride) Finasteride Male Pattern Hair Loss Study Group. Long-term (5-year) experience with finasteride 1 mg in androgenetic alopecia. European Journal of Dermatology, 2002;12(1):38-49. (Oral finasteride; topical finasteride is not FDA-approved and is absorbed systemically.) → PubMed
³ Latanoprost and ketoconazole each showed modest hair-density benefit in small studies Blume-Peytavi U, Lönnfors S, Hillmann K, Garcia Bartels N. A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia. JAAD, 2012;66(5):794-800. And: Piérard-Franchimont C, et al. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology, 1998;196(4):474-477. → PubMed · PubMed
How it Works With EHRX
The entire process is online. No waiting rooms. Just straightforward, medically guided care.
Step 1
Choose your treatment and complete checkout
You'll receive a confirmation email with next steps.
Step 2
Complete a brief medical consultation
Check your email for a link to a short intake form and link to a virtual consult with a licensed physician.
Step 3
A licensed provider reviews your consultation
If approved, your prescription is written and sent to the pharmacy. If not, you receive a full refund.
Step 4
Your pharmacy ships within 3–5 business days
Your medication is shipped directly to your door in temperature-controlled packaging.
What to know before you start.
Minoxidil 5% / Finasteride / Latanoprost / Ketoconazole Spray is a compounded medication prepared by a licensed pharmacy for individual patient use.
It has not been reviewed by the FDA for safety or efficacy, and is prescribed based on the clinical judgment of a qualified healthcare provider. Compounded drugs are permitted to be prescribed but are not FDA-approved for safety and efficacy.
Clinical Evidence
Each component has individual support. Minoxidil and finasteride are established. Latanoprost showed effects on hair thickness in small scalp trials. Ketoconazole shampoo has been shown to support hair growth in studies of androgenetic alopecia. (Source: Hugo Perez, Skinmed, 2004)
Frequently Asked Questions
We aim to provide absolute clarity regarding your biological data and personalized wellness protocols.
Once or twice daily to dry scalp, massaging gently into thinning areas.
Latanoprost is FDA-approved for glaucoma; eyelash thickening is a known side effect that led to investigation for scalp hair, where small studies have shown effects on shaft thickness and growth.
Initial shedding in the first 4 to 8 weeks is normal. Visible regrowth typically takes 4 to 6 months.
Not typically required.
You won’t be charged for the medication.
No. Compounded topical formulas are paid out of pocket.
Yes, at any time before your next shipment, with no long-term commitment.
Initial check-in at 3 to 6 months to assess response, then on a recurring cadence.
Your provider may add adjuncts (oral finasteride, oral minoxidil), increase frequency, or recommend procedures like PRP or transplantation.
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