Medication information for the patient
Please also read any patient information that comes with your medication from the manufacturer as well as the medication information given to you by your pharmacist. The following information is meant to highlight certain information and is not comprehensive. 

Spironolactone (Aldactone) is a water pill (diuretic) used for its anti-androgen (anti-male hormone) side effect. It competes with dihydrotestosterone in the skin. Your pharmacy information most likely will not mention anything about using spironolactone for acne or scalp hair loss since these were found to be beneficial side effects for women after the medication was already FDA approved decades ago as a water pill. It is most commonly prescribed as a medication for high blood pressure and heart failure. 

  • Women should not take this pill if they are pregnant or trying to get pregnant (Pregnancy Category D). Since this medication blocks the male hormone, a male baby’s genitals may not form correctly. This could only occur if you were taking this medication while you were pregnant. Therefore, you should take precautions to not get pregnant while taking spironolactone. There is no concern for a long-term risk of birth defects once you have stopped the spironolactone. We recommend that you stop spironolactone 1 month before you would try to get pregnant.

  • This medication may cause some breast tenderness or menstrual spotting, especially when just starting the medication. Rarely, some patients have had an “extra” period of have “skipped” a period when just starting the medication. If you miss a period, make sure that you are not pregnant by taking a pregnancy test. Stop spironolactone immediately if you are pregnant.

  • Spironolactone has been reported to help PMS symptoms; however, rarely, it may make PMS symptoms worse.

  • Very rarely, patients on spironolactone may notice increased urination. Other rare side effects include possible weakness, dizziness, or feeling lightheaded when going from a sitting or lying down position to a standing position (orthostatic hypotension). Spironolactone may slightly decrease your blood pressure.

  • Avoid excess ingestion of foods high in potassium and salt substitutes, since spironolactone makes your body hold onto more potassium than usual. Depending on your age and medical conditions, your potassium level may be checked by bloodwork. Please let us know if you are started on an ACE inhibitor medication (often given for high blood pressure) or Yasmin (a birth control pill containing drosperidone which is equivalent to about 25 mg of spironolactone), since these can also increase your potassium. Signs of high potassium include muscle weakness, fatigue, numbness, tingling, and irregular heartbeat. If you notice any of these symptoms, please notify the office, as we may need to check your blood potassium level.

  • Spironolactone may be taken with or without food. Your dermatologist may prescribe this with antibiotics for acne or with birth control pills.

  • Two different methods may be used to start spironolactone, both resulting in taking a total of 100 mg a day:

                1. Spironolactone 25 mg via the slow increase dose method 

                    Week 1: Take 1 tablet in the morning 

                    Week 2: Take 1 tablet in the morning and 1 at dinner. 

                    Week 3: Take 2 tablets in the morning and 1 at dinner. 

                    Week 4: Take 2 tablets in the morning and 2 at dinner. 

                2. Spironolactone 50 mg taken twice a day