Spironolactone

Written by Sarah Lewis, PharmD
Medically reviewed by Dena Westphalen, PharmD
Updated on June 16, 2023

Specifically, the Food and Drug Administration (FDA) has approved spironolactone to:

• treat fluid buildup related to liver or kidney disease
• manage fluid buildup and reduce the risk of hospitalization and death in people with heart failure
• treat high blood pressure with other high blood pressure medications
• treat primary hyperaldosteronism (a condition in which the adrenal glands make too much aldosterone hormone)

This article describes spironolactone’s uses, side effects, and more. Below you’ll also find some coupon options to help save on the cost of spironolactone.

Below are answers to a few commonly asked questions about spironolactone.

Can spironolactone be used for acne or hair loss?

Possibly. Spironolactone isn’t approved to treat acne or hair loss. But doctors may decide to prescribe it for either of these purposes. This is called off-label use. Off-label use is when doctors prescribe a drug for a condition other than its approved uses.

To learn more about taking spironolactone for acne or hair loss, talk with your doctor.

Is it safe to take spironolactone with potassium supplements?

No, you should not take spironolactone with potassium supplements, including salt substitutes. Doing so could lead to very high levels of potassium in the blood. This condition could become life threatening.

Symptoms of very high potassium levels can include:

• chest pain
• heart palpitations (fluttering or skipping feeling)
• muscle weakness
• nausea or vomiting

If you experience any of these symptoms, seek immediate medical care or call 911 or a local emergency number.

Talk with your doctor or pharmacist to find out more about avoiding sources of potassium while taking spironolactone.

Does spironolactone come in a topical form?

No, there isn’t a manufactured topical form of spironolactone. (Topical means the drug is applied on your skin.) However, some pharmacies are able to compound (custom-make) a topical form of the drug. (Compounding pharmacies create custom-made medications.)

To learn more about these types of pharmacies, talk with your doctor or pharmacist.

What brand names are available for spironolactone?

Spironolactone oral tablet is available as the brand-name drug Aldactone. Spironolactone oral liquid suspension (a type of liquid mixture) is available as the brand-name drug CaroSpir.

If you’d like to know more about these brand-name versions, talk with your doctor or pharmacist.

Is spironolactone similar to furosemide?

Yes, spironolactone and furosemide are similar drugs. They’re both diuretics (water pills) and help the body get rid of extra fluid. But they’re different kinds of diuretics.

Spironolactone is a potassium-sparing diuretic. It helps your body hold on to potassium while disposing of fluid. Furosemide is a loop diuretic. It helps your body get rid of potassium, along with extra fluid.

People who take furosemide may also need a potassium supplement. But people who take spironolactone should avoid potassium supplements. For more details, see the “Is it safe to take spironolactone with potassium supplements?” section.

If you’d like to know more about how these drugs compare, talk with your doctor or pharmacist.

How does spironolactone work? And how long does it take to start working?

Spironolactone works by blocking the actions of aldosterone. Aldosterone is a hormone that manages fluid and salt balance in the body. It tells your body to hold on to water. In the process of holding on to water, your kidneys get rid of potassium. Spironolactone works to block these effects.

Spironolactone will start working soon after you take it. For fluid buildup, it can take up to 5 days to see its full effect. For high blood pressure, it can take up to 2 weeks to see how well it’s working. If you’re taking the drug for primary hyperaldosteronism, you can talk with your doctor or pharmacist to find out how long it’ll take to work.

If you’d like to know more about how spironolactone works, talk with your doctor or pharmacist.

The Food and Drug Administration (FDA) approves prescription drugs such as spironolactone for certain conditions. Approved uses for spironolactone are described below.

Use for heart and blood vessel problems

Doctors may prescribe spironolactone oral tablet for treating high blood pressure. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

With high blood pressure, your blood pressure is higher than average. There are no symptoms in most cases. But having high blood pressure increases your risk of serious complications. This includes heart attack and stroke, which can be fatal. Lowering your blood pressure helps prevent these problems.

Spironolactone is prescribed together with other blood pressure medications.

Doctors may not prescribe spironolactone oral tablet for certain people. This includes people who take the drug eplerenone (Inspra) or people who have high potassium levels or Addison’s disease.

Use for fluid buildup

Doctors may prescribe spironolactone oral tablet for treating edema (fluid buildup). It’s used for this purpose in adults. Spironolactone is usually prescribed as a long-term treatment.

With fluid buildup, too much water becomes trapped in the body’s tissues. This causes swelling. Fluid buildup can happen anywhere but is most common in the legs, ankles, and feet. Fluid buildup can occur with heart failure, liver disease, or kidney disease. Spironolactone is a diuretic (water pill). So it helps get rid of extra fluid in your body.

Spironolactone is usually prescribed together with other medications for heart failure.

Doctors may not prescribe spironolactone oral tablet for certain people. This includes people who take the drug eplerenone (Inspra) or who have high potassium levels or Addison’s disease.

Use for high aldosterone levels

Doctors may prescribe spironolactone oral tablet for treating primary hyperaldosteronism (high aldosterone levels). It’s used for this purpose in adults. Spironolactone is prescribed as a short-term treatment before surgery or a long-term treatment in people who aren’t having surgery.

With high aldosterone levels, the adrenal gland makes too much aldosterone. Aldosterone is a hormone that manages water and salt balance in the body. Signs and symptoms can include high blood pressure, low potassium levels, and fatigue (low energy).

Doctors may not prescribe spironolactone oral tablet for certain people. This includes people who take the drug eplerenone (Inspra) or who have high potassium levels or Addison’s disease.

Below, you’ll find information about spironolactone’s possible interactions and warnings.

Interactions of spironolactone

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take spironolactone, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription drugs
• over-the-counter medications
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for spironolactone” section.

Warnings for spironolactone

Some people should not take spironolactone, and others should take it cautiously.

Spironolactone could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether spironolactone is a safe option for you. These warnings may differ based on the form of spironolactone you take.

Ask your doctor about specific warnings for spironolactone, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Spironolactone can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to spironolactone or any of its ingredients, your doctor will likely not prescribe spironolactone. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• severe skin rashes that may blister and peel
• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to spironolactone, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of spironolactone

If you take spironolactone by mouth, you should not take more than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much spironolactone, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and spironolactone

Information about spironolactone and pregnancy and breastfeeding is described below.

Spironolactone and pregnancy

Spironolactone should not be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication. Your doctor may suggest birth control options to use during treatment with spironolactone.

Spironolactone and breastfeeding

It’s not known whether spironolactone should be taken while breastfeeding. If you’re breastfeeding or planning to do so, talk with your doctor before taking this medication.

Spironolactone may cause mild or serious side effects. More common mild side effects of spironolactone and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about spironolactone’s side effects, see this article or ask your doctor or pharmacist. You can also read the prescribing information for spironolactone in the “Article resources” section.

Mild side effects

More common mild side effects reported with some forms of spironolactone are listed below. This article doesn’t include all possible mild side effects of the drug.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Spironolactone oral tablet’s mild side effects include:

• dizziness
• drowsiness
• headache
• nausea
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for spironolactone” section.

Serious side effects

Serious side effects of spironolactone are listed below. This article doesn’t include all possible serious side effects of the drug.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, spironolactone’s serious side effects include:

• changes in blood cell levels
• changes in menstrual periods, including bleeding after menopause
• dehydration
• problems with electrolytes, such as high potassium levels
• liver problems
• low blood pressure
• new or worsening kidney problems
• sexual problems
• sores or bleeding in your digestive system
• growth of breast tissue in males*
• severe allergic reaction†

*  Sex and gender exist on spectrums. In this article, we use the term “male” to refer to a person’s sex assigned at birth.
† For details about this side effect, see the “Interactions and warnings for spironolactone” section.

This article describes spironolactone’s uses and side effects, ways to save on cost, and more. Let your doctor know if you have questions about spironolactone or would like more details about it.

Here’s a list of some questions you may want to ask your doctor:

• How does spironolactone compare to other drugs that could treat my condition?
• Do any of my other medications interact with spironolactone?
• Are there certain foods I should avoid or limit while taking spironolactone?
• Do I have a higher risk of side effects for any reason?

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Spironolactone tablets for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/c328f555-2da8-43ac-bc04-0e89d4d2aa53/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.