medication information


We want to make sure you fully understand your treatment. 
Below outlines the directions, benefits and risks with Spironolactone.

Spironolactone targets acne that is hormonal and flares before or during your menstrual cycle. This acne is often concentrated on the lower face, jawline, and neck. It can cause a mild decrease in blood pressure that can cause you to feel dizzy or lightheaded. For some patients, taking their entire dose at night can help to eliminate this side effect. Following the tips below will also help.

It is essential that you do not get pregnant on this medication due to the risk of birth defects. Should you decide to try for pregnancy or find out you are pregnant, you should stop the medication right away. If you think there is any chance you may be pregnant before starting the medication, please take a pregnancy test before starting the medication.


Start out slowly. 🐢 You can start by taking 1/2 a pill (or half your dose) daily for the first week and increase to 1 full pill thereafter if you are tolerating the medication well.

Drink plenty of water. 💦 Spironolactone is a diuretic that will make you urinate more frequently. It’s important to stay hydrated by drinking plenty of fluids throughout the day. This can help you avoid feeling dizzy or lightheaded.

Take at night. 🌙 Taking the medication at night can also help minimize side effects. Just don’t load up on fluids right before bedtime.

Take with food. 🥗 Spironolactone may cause stomach upset or nausea. Taking it with food can help. Some doctors recommend taking this pill after dinner.

Review your birth control options. 📝 You should take extra precautions to avoid pregnancy while taking spironolactone. There are many birth control options to consider.

Irregular menstrual cycles or spotting can occur at higher doses of spironolactone. Birth control pills would help regulate your period and prevent spotting. The most effective birth control pill for acne is Yasmin followed by Ortho-tri-cyclen.

Take as instructed. 👩🏻‍⚕️ Be consistent for best results. It takes 2-6 months to reach maximal effect.

Do NOT take this medication if:

  • You take potassium supplements or drugs that increase potassium levels such as lisinopril or bactrim.

Review with your prescriber prior to taking this medication if:

  • You have a history of kidney or heart disease.


Spironolactone is a diuretic with anti-androgenic properties that is used off-label to treat acne. Other possible side effects include breast tenderness, mild headaches, irritability and breast enlargement. Most mild side effects tend to improve with time.

Very rarely, elevations in liver function or potassium levels can occur, especially in patients with a history of kidney disease. Unless recommended by your prescriber, there is no need for lab work if you have no underlying kidney problems.

Having a personal or family history of breast, uterine or ovarian cancer is not a contraindication to treatment with spironolactone (reference here and here). If you have specific questions or concerns, please reach out to your dermatologist or primary care provider.

If your dermatologist also prescribed an oral antibiotic for you, you can take both at the same time.

Make sure to update your medication lists and discuss any new medications you are taking with your primary care provider.

Stop this medication and notify your Apostrophe doctor if you develop hives, muscle cramps, weakness, cardiac irregularities, drowsiness, a rash or any other unusual or persistent symptoms.