Oral Spironolactone

Spironolactone is an oral medication that acts as a mild diuretic that has anti-androgen effects. Dermatology providers prescribe spironolactone off-label to treat hormonal acne in adult women.


  • Do not use if you are pregnant, attempting to become pregnant, or at high risk of pregnancy.
  • If you think you may be pregnant, take a pregnancy test prior to starting this medication.
  • Drink plenty of fluids throughout the day to avoid dehydration and lightheadedness.
  • Spironolactone can cause birth defects. You should use a reliable form of birth control to prevent pregnancy while taking spironolactone. Stop taking this medication if you become pregnant and notify your dermatology team immediately.
  • Do not take with potassium supplements or drugs that increase potassium levels. If you have a history of elevated potassium level, kidney or heart disease, or take any blood pressure lowering medications that you have not reported to your dermatology team, please do not start this medication without discussing it first with your provider.


  • Take medication as directed by your dermatology team.
  • This medication can be taken with or without food.
  • If you were also prescribed an oral antibiotic to treat your acne, the two medications can be taken at the same time.


  • The most common side effects of spironolactone are increased urination, headache, fatigue, dizziness, menstrual irregularities, breast tenderness, breast enlargement, nausea, vomiting, and stomach pain.
  • Hyperkalemia (elevated serum potassium levels) is a reported serious side effect of spironolactone but this side effect is rare in women less than 45 who do not have kidney or heart disease. The main symptoms of hyperkalemia are muscle weakness or paralysis and irregular heartbeat.
  • Stop use of the medication and notify your dermatology team if you develop hives, muscle cramps, weakness, irregular or racing heartbeat, chest pain, drowsiness, a rash, or any other unusual or persistent symptoms.


  • Keep this medication in the container it came in, tightly closed, and out of reach of children.
  • Store it at room temperature and away from light, excess heat, and moisture.