What is it?

Spironolactone is an anti-male hormone (anti-androgen) medication. It blocks the male hormone receptor and reduces the level of the male hormones, testosterone and DHEAS.

Spironolactone has a diuretic (“fluid tablet”) effect and increases urine production. This medication lowers blood pressure and reduces fluid retention seen in conditions such as heart failure and chronic liver disease. Spironolactone can be used to treat low potassium levels (hypokalaemia).

What is it used for?

In dermatology Spironolactone is mainly used to treat Acne, Hirsutism (excessive hormonal hair), Hidradenitis suppuritiva and Female pattern hair loss.

What precautions should you take with this medication?

  • Spironolactone may cause birth defects or miscarriage. Do not fall pregnant whilst taking this drug. If you think you may be pregnant, stop taking the drug immediately and contact your dermatologist
  • Do not take Spironolactone if you have renal impairment or Addison’s disease
  • Do not breastfeed while taking Spironolactone
  • Do not take Spironolactone if you are taking other potassium-sparing agents, ACE-inhibitors or angiotensin II antagonists, digoxin, steroids, other diuretics (fluid tablets)
  • Let your doctor know if you have a family history of breast or ovarian cancer.

What monitoring is required when taking it?

A blood test is required before, and during, treatment with Spironolactone to monitor kidney function and electrolyte levels (especially potassium). Your blood pressure may also be monitored.

What to expect while taking it and possible side effects:

  • The desired effects of Spironolactone take months to develop and it may take 6 months or longer before you see an improvement in your condition
  • Spironolactone maycause dizziness or light-headedness. Have your doctor check your blood pressure if you experience any of these symptoms. Ensure you drink enough water throughout the day. Taking the Spironolactone at night may help alleviate the severity of these symptoms
  • Spironolactone may cause headaches, nausea or diarrhoea
  • Spironolactone may make your period cycle (menstruation) irregular. Periods may stop altogether or spot bleeding may be experienced in between normal periods
  • Spironolactone may cause breast changes that are benign (harmless). Enlargement (gynaecomastia), swelling or tenderness of the breasts can occur
  • Leg cramps
  • Some people report a decreased libido (sex-drive) while taking this medication

Tell your dermatologist if you experience any of the above mentioned or other side-effects. In most cases, side effects improve when you stop treatment.

Other potential side effects have been reported. Please refer to the product information that is provided with the medication. Ensure you have read this and understand it before taking this medication.

This information has been written by Dr Eleni Yiasemides


2019 © Australasian College of Dermatologists.

You may use for personal use only. Please refer to our disclaimer.