Spironolactone oral tablet is prescribed for certain conditions in adults, including high blood pressure. It’s a diuretic drug that may cause mild or serious side effects, including a high potassium level in the blood and breast growth in some people.
Specifically, the Food and Drug Administration (FDA) has approved spironolactone oral tablet to treat:
- heart failure
- high blood pressure, used with other medications
- fluid retention and swelling in people with certain kidney or liver disease
- primary hyperaldosteronism
This article describes possible side effects of spironolactone oral tablet. You’ll also find information on cost savings and coupon options for spironolactone.
Spironolactone oral tablet is a generic version of the brand-name drug Aldactone. Spironolactone also comes as a brand-name liquid suspension called CaroSpir. This is a type of liquid mixture that you swallow.
You can view this overview article to learn more about spironolactone oral tablet, including the drug’s uses, dosage, ways to save on cost, and more.
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More common side effects of spironolactone
Spironolactone oral tablet may cause mild or serious side effects. Below are some of the more common side effects of this medication.
In studies, common side effects of spironolactone oral tablet include:
- dizziness
- sleepiness
- breast growth in males*†
- leg cramps
- nausea
* To learn more about this side effect, see the “Side effects of spironolactone in detail” section below.
† Sex and gender exist on spectrums. In this article, we use the term “male” to refer to a person’s sex assigned at birth.
Mild side effects of spironolactone
Spironolactone may cause certain mild side effects. Usually, mild side effects are temporary and can be easily managed. Tell your doctor or pharmacist if you have side effects that don’t go away or become bothersome.
Mild side effects of spironolactone oral tablet that occurred in studies include:
- breast or nipple pain
- confusion
- diarrhea and stomach cramping
- dizziness
- sleepiness
- headache
- itching
- leg cramps
- period changes, such as irregular or missed periods
- nausea or vomiting
- mild allergic reaction*
Spironolactone oral tablet may cause more mild side effects than those listed above. For details, see the drug’s prescribing information.
* To learn more about this side effect, see the “Side effects of spironolactone in detail” section below.
Serious side effects of spironolactone
Spironolactone may cause certain serious side effects. If you have any serious side effects from spironolactone oral tablet, call your doctor right away. But if you think you’re having a medical emergency or your side effects feel life threatening, take immediate action. Call 911 or a local emergency number or go to the nearest emergency room.
After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Visit MedWatch’s website if you’d like to notify the FDA about a side effect you’ve had with spironolactone oral tablet.
Serious side effects of spironolactone oral tablet that occurred in studies include:
- changes in certain blood cell counts, including low white blood cells and low platelets
- dehydration (low fluid level in your body), which can cause low blood pressure
- kidney problems, including kidney failure
- liver problems, including liver damage
- sexual difficulties, such as decreased sex drive or erectile dysfunction (ED)
- stomach inflammation, ulcer, or bleeding
- high potassium level in the blood and other changes in blood levels*
- breast growth in males*†
- serious skin reactions*
- severe allergic reaction*
* To learn more about this side effect, see the “Side effects of spironolactone in detail” section below.
† Sex and gender exist on spectrums. In this article, we use the term “male” to refer to a person’s sex assigned at birth.
Common questions about side effects of spironolactone
Here are answers to some common questions about side effects of spironolactone oral tablet. If you have other questions, talk with your doctor or pharmacist.
Does spironolactone cause certain side effects in women?
Yes, reported side effects of spironolactone oral tablet include changes in periods and bleeding in females.* These included:
- irregular periods
- missed periods
- vaginal bleeding after menopause
Call your doctor right away if you have changes in your periods or unusual bleeding. They can determine the most likely cause and suggest ways to manage your symptoms.
* Sex and gender exist on spectrums. In this article, we use the term “female” to refer to a person’s sex assigned at birth.
Can a low dose of spironolactone, such as 25 mg, cause different side effects than higher doses?
No, low doses of spironolactone won’t cause different side effects than higher doses.
That said, most side effects of spironolactone oral tablet are dose related. The drug’s dosages are written in milligrams (mg).
This means people tend to tolerate lower doses better and side effects are more common or worsen as the dose increases.
At higher doses, high potassium levels in the blood and side effects related to sex hormones may worsen. Spironolactone can interfere with sex hormones, such as testosterone.
With dose increases, there’s an increased risk of:
- breast growth in males*†
- breast pain
- sexual difficulties
- period problems
If you have side effects after a dosage increase, call your doctor. They may be able to suggest ways to manage your symptoms or recommend a change in your treatment plan.
* To learn more about this side effect, see the “Side effects of spironolactone in detail” section below.
† Sex and gender exist on spectrums. In this article, we use the term “male” to refer to a person’s sex assigned at birth.
Is weight gain a side effect of spironolactone?
Weight gain wasn’t reported as a side effect in studies of spironolactone oral tablet.
That said, fluid retention can cause weight gain. Doctors often prescribe spironolactone oral tablet to help remove extra fluid from the body. If you experience weight gain, it could be a sign that the drug isn’t working as well as it should. It could also mean that your condition is worsening. So, it’s important to call your doctor right away about any weight gain.
Spironolactone oral tablet can also interfere with sex hormones, which might affect your weight.
Your doctor can determine the most likely cause of your weight gain and suggest ways to manage it.
Can spironolactone be taken for acne? If so, does it cause side effects when used for acne?
Yes, doctors sometimes prescribe spironolactone off-label to treat acne and some other conditions. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.
Guidelines from the American Academy of Dermatology recommend spironolactone as an option for treating acne in certain females.* But the guidelines do not recommend the drug for treating acne in males.*
Spironolactone can cause side effects in people who take the drug to treat acne. But side effects of the drug for treating acne are likely similar to side effects for its approved uses, according to one study.
To learn more about spironolactone for acne treatment, talk with your doctor. They can answer questions about the drug’s uses, side effects, and more.
* Sex and gender exist on spectrums. In this article, we use the terms “female” and “male” to refer to a person’s sex assigned at birth.
Does spironolactone cause long-term side effects?
Some of spironolactone oral tablet’s side effects are long lasting due to the way the drug works. It blocks the effects of aldosterone (a hormone the adrenal gland makes). This helps the kidneys get rid of extra fluid. But it also has effects on potassium, electrolytes, and other hormones.
Talk with your doctor if you have side effects that aren’t going away or become bothersome or serious. They can help determine the most likely cause of your symptoms. They can also suggest ways to manage the problem or may recommend a change in treatment.
Side effects of spironolactone in detail
Below you’ll find details on some of the side effects of spironolactone oral tablet.
High potassium levels and other changes in blood levels
High potassium levels can occur with spironolactone oral tablet due to the way the drug works. Spironolactone oral tablet is called a potassium-sparing diuretic. This means it makes your body hold on to potassium. Sometimes, potassium levels can become too high.
Mildly elevated potassium levels may not cause any symptoms. When symptoms do occur, they can include:
- chest pain
- fatigue
- heart palpitations (feeling of skipped or extra heartbeats)
- muscle weakness
- nausea or vomiting
- numbness or tingling
- shortness of breath
The risk of a high potassium level is increased in people with kidney problems or those who take:
- potassium supplements
- salt substitutes that contain potassium
- other drugs that increase potassium levels, such as angiotensin converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs)
Other changes in blood levels can also occur as a side effect of spironolactone oral tablet. These include changes in certain electrolytes and minerals, such as:
Ways to manage
Due to the risk of high potassium levels and other changes in blood levels, doctors regularly order blood tests to check these levels.
For example, doctors usually check potassium levels a week after you start treatment with spironolactone oral tablet. They’ll also check your levels after dosage increases and periodically during treatment.
If you have any of the symptoms of high potassium levels listed above, call your doctor right away. A high potassium level can be dangerous. It can cause serious heart problems.
If you develop a high potassium level or other blood chemistry changes, your doctor may recommend reducing your dosage. Or they may recommend that you stop taking spironolactone oral tablet and start another treatment.
Breast growth in some people
Spironolactone may cause breast growth in males* taking the drug. Other symptoms may include:
- breast swelling
- breast tenderness
This was the most commonly reported side effect of spironolactone oral tablet. It’s more likely to occur with higher doses of the drug. It can occur within 1 to 2 months of starting treatment with spironolactone oral tablet. But it may take over 1 year of treatment to happen.
* Sex and gender exist on spectrums. In this article, we use the term “male” to refer to a person’s sex assigned at birth.
Ways to manage
Tell your doctor right away if you notice breast symptoms while taking this drug. They’ll likely recommend stopping treatment. This side effect from spironolactone oral tablet is usually reversible.
Serious skin reactions
Serious skin reactions can occur with spironolactone oral tablet. These reactions are life threatening and can be fatal when they do occur. These reactions include:
- Stevens-Johnson syndrome (a condition that causes painful sores and rash that affect your mouth, throat, eyes, or genitals)
- toxic epidermal necrolysis (a serious skin rash that covers more than 30% of your body)
- drug rash with eosinophilia and systemic symptoms (a serious drug reaction affecting the skin and other organs)
Symptoms of these serious reactions can include:
- blisters
- hives (itchy welts on your skin)
- mouth sores
- peeling skin
- severe, widespread rash
Ways to manage
Call your doctor right away if you develop a rash while taking spironolactone oral tablet. If you have any symptoms listed above, seek emergency medical care or call 911. Without prompt treatment, these serious skin reactions can become life threatening.
Allergic reaction
For some people, spironolactone oral tablet can cause an allergic reaction.
Symptoms can be mild or serious, and they may include:
- itchiness
- skin rash
- swelling under the skin, usually affecting eyelids, lips, hands, or feet
- swelling of the mouth, tongue, or throat, which can make it hard to breathe
- flushing (temporary warmth, redness, or deepening of skin color)
Ways to manage
For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication.
For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to spironolactone oral tablet, your doctor may recommend taking a different medication instead.
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