Spironolactone is an oral medication that is taken as a pill. Although it is a diuretic (i.e., a water pill) used to treat high blood pressure, it has useful anti-androgen effects. Many dermatologists prescribe spironolactone off-label to treat hormonal acne in adult women.
Take the medication exactly as instructed by your dermatologist.
DO NOT take this medication if:
- You become pregnant, as it can cause birth defects.
- You have a history of kidney or heart disease, or a history of breast cancer, uterine cancer, or ovarian cancer.
Tips to avoid side effects:
- Drink plenty of water, as this medication acts as a diuretic.
- If the medication upsets your stomach, take it with a meal.
- Rise slowly from a seated or lying position to prevent dizziness.
- Spironolactone should not be taken with potassium supplements or with drugs that increase potassium levels.
Risks to be aware of:
- The most common side effects are headache/dizziness, nausea, upset stomach/diarrhea, painful periods and cramping, irregular periods, breast tenderness, and breast enlargement.
- Spironolactone can cause birth defects, so you should not become pregnant while taking it. Please notify your primary care doctor or OB/GYN that you have been placed on spironolactone and use birth control.
- Spironolactone is best taken with a birth control pill. The combination is often more effective for acne, and birth control pills will minimize the side effects from spironolactone.
- Spironolactone can raise potassium levels, but this is unlikely in otherwise healthy young adults with normal kidney function. Clinical guidelines published by the American Academy of Dermatology state that lab monitoring is not necessary for this subset of patients.
- Patience and consistent usage is key! Spironolactone only works if you take it regularly and correctly.
Note: if you are taking an oral antibiotic in conjunction with spironolactone, your allergic reaction may be due to the oral antibiotic. Make sure to stop both the spironolactone and the oral antibiotic if you experience any hives, difficulty breathing, swelling of your face, lips, tongue, or throat, or any of the other symptoms below.
Tell your doctor right away if you have any serious side effects, including: increased thirst, signs of kidney problems (such as changes in the amount of urine), mental/mood changes, unusual fatigue/weakness, muscle spasms, severe stomach/abdominal pain, persistent nausea/vomiting, vomit that looks like coffee grounds, dark urine, yellowing of the eyes/skin, and easy bruising/bleeding.