Spironolactone

Spironolactone works by controlling naturally occurring hormones to reduce oil production and keep pores clear. Since men and women both produce hormones like testosterone, the medication works internally by regulating the production of testosterone to result in clearer skin. Because of the reduction in testosterone, men should not use spironolactone as an acne treatment.

Typically, results occur within the first few weeks of use. Skin continues to improve with consistent and regular use of your medication.

Spironolactone is taken by mouth in tablet form.Tablets are prescribed according to the treatment and patient history and come in three different strengths, depending on your provider's instructions. Tablets may cause stomach upset; you should take the pill with food if this happens to you. Be sure to take the tablet at the same time each day and in the same manner, so if you take the pill with food, take it with food consistently. Taking your medication a few hours before bedtime can reduce sleep interruptions caused by late-night trips to the bathroom.

Never decrease, increase, or stop taking your medication without consulting with your provider to prevent worsening your condition.

Keep the container tightly closed and store your medication at room temperature and away from sunlight and heat. Keep this and all medications away from children and pets, and never share your medication.

Spironolactone may contribute to elevated potassium, especially for those with existing kidney problems. Elevations of this mineral can be dangerous and result in a slow or irregular heartbeat or muscle weakness. While taking spironolactone, limit foods high in potassium like bananas, tomatoes, potatoes, prunes, raisins, orange juice, and low-salt milk.

Talk to your provider about allergies. Even if you have no allergy to spironolactone, tablets may contain ingredients that could trigger an allergic reaction. Although these reactions are rare, get medical help right away if you experience symptoms of an allergic reaction such as rash, itching or swelling of the face, tongue, or throat, severe dizziness, or trouble breathing.

Spironolactone can make you drowsy. Avoid alcoholic beverages or marijuana, as these can increase the effect. Do not drive or perform similar functions that require your full attention.

Side effects are fairly common and typically happen as the body adjusts to medication. Side effects usually go away on their own with continued use of your medicine. Older adults may find they are more sensitive to side effects.

Common side effects reported by spironolactone users are drowsiness, lightheadedness, stomach upset, diarrhea, nausea, vomiting, menstrual irregularities, or headache. To reduce instances of lightheadedness, rise slowly from a lying or sitting position to allow your blood pressure time to adjust. Notify your provider if symptoms persist or worsen.

Serious side effects are rare but can occur. Alert your provider and seek medical help if you experience serious side effects such as increased thirst, changes in urine production, mood changes, unexplained fatigue, muscle spasm, period changes, or changes in the breast.

Spironolactone can interact with other medications to worsen your condition or interfere with medications and reduce their effectiveness. Tell your provider about all prescription and over-the-counter medications or remedies along with herbal supplements you're taking to determine if spironolactone is right for you.

Let your provider know about specific medications such as lithium or drugs with potassium. These drugs include amiloride, cyclosporine, eplerenone, tacrolimus, triamterene, or birth control pills that contain drospirenone. Avoid the risk of elevated potassium levels by not taking supplements while you're taking spironolactone unless otherwise indicated by your provider. Tell your provider about your use of cold remedies and ibuprofen.

Spironolactone can interfere with lab results and cause false test results. Tell your provider about tests or surgeries you have scheduled or plan to schedule.

If you miss taking your medication, take it as soon as you remember. If you remember late and it's now close to the second dose, take your regular dose and resume your normal schedule the following day. Don't increase your dose or try to catch up since this can cause adverse effects and won't improve your condition.

Spironolactone is not safe if you are pregnant, planning a pregnancy, or breastfeeding.

Spironolactone is not FDA-approved specifically for the treatment of acne, but it is widely prescribed off-label by dermatologists, particularly for hormonal acne in women. It is often used as an alternative to long-term antibiotic treatments due to its ability to reduce androgen-driven oil production, a key factor in acne. Extensive medical literature supports its efficacy and safety in managing acne, making it a common choice for dermatologists seeking to provide effective, sustainable treatment options.