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Does Spironolactone Cause Weight Gain?

Mary Lucas, RN

Medically reviewed by Mary Lucas, RN

Written by Our Editorial Team

Last updated 2/18/2022

Sometimes, finding the right drug can feel like you’re stuck in a back-and-forth situation.

A pill that may prevent pregnancy might cause blood clots. A drug that decreases anxiety may cause drowsiness. And a pain reliever may make you nauseous. 

There are also many medications that can help with acne, but some drugs may have side effects that may leave you feeling like you need to choose between the lesser of two evils. 

For example, spironolactone (sold under the brand name Aldactone®) is sometimes prescribed to treat acne (among other conditions), but some women who’ve use it have reported experiencing weight gain while taking it.

So, is weight gain while taking spironolactone something you should worry about? And what does the science have to say about spironolactone and weight gain? Or the Food and Drug Administration (FDA), for that matter?

But first…

What Is Spironolactone?

While it may sound like a prehistoric dinosaur, spironolactone did not roam the earth battling the T. rex for turf. Sorry to disappoint. 

Fantastic name aside, spironolactone is actually an oral medication that healthcare professionals may prescribe to treat many conditions, including hypertension (high blood pressure), heart failure and edema. 

Spironolactone also has off-label uses.

“Off-label” is a term used to describe medications that have shown clinical promise in the treatment of things other than what they originally gained approval from the FDA for. 

Healthcare professionals will sometimes prescribe medications off-label if traditional treatment methods prove ineffective, if patients experience certain side effects or if there are other issues at play — things like an increased potential for an allergic reaction to traditional treatments or other external issues like drug interactions.

We’ve talked more about how and why certain medications get prescribed off-label in our article, A Patient’s Guide to Off-Label Drug Use and Prescribing.

In the case of spironolactone, off-label uses include the treatment of bloating and weight gain due to PMS, polycystic ovary syndrome, hirsutism (facial hair in women) and, perhaps most popularly, acne vulgaris

What About Spironolactone and Weight Gain?  

Now that we understand spironolactone and what it’s used to treat, let’s hop into the topic at hand: spironolactone and weight gain.

Spironolactone, like every prescription medication, does have certain side effects associated with its use, weight gain doesn’t appear to be one of them.

While weight gain is listed as a possible side effect of spironolactone on some credible medical websites, it’s not listed as a side effect on the drug’s FDA package insert — which is pretty much the end-all-be-all of relevant prescribing information.

In fact, spironolactone is a diuretic — or water pill — which means that it causes your body to get rid of salt and water. Diuretics are often used to reduce blood pressure. 

Typically, when your body loses water, it loses weight (although it’s not a healthy form of weight loss), so it would seem unusual to actually gain weight because you’re taking spironolactone, which is associated with potential weight loss. 

Additionally, clinical studies do not suggest that spironolactone causes weight gain. 

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What Are the Common Side Effects of Spironolactone?

So, what are some of the more common side effects of spironolactone? 

There’s a pretty long list of things to watch out for — including bloody gums, breast tenderness, constipation, loss of appetite, irregular heartbeat, nausea and sore throat, to name a few. 

Taking birth control along with spironolactone may help alleviate some of the adverse effects, like irregular periods, breast enlargement and breast pain. 

Additionally, it’s also useful to take birth control with spironolactone because if you become pregnant while on the medication, it may cause serious birth defects.

Like with any drug, if you’re experiencing any adverse effects, it’s important to inform your healthcare provider immediately.

Using Spironolactone to Control Acne

If you’ve run out of other options to help get your acne under control, it’s definitely worth having a conversation with and getting medical advice from your healthcare provider about the beneficial effects of spironolactone in the treatment of acne.

As an acne medication, spironolactone is only prescribed to females because it can cause breast growth in men. 

However, for females, it’s considered an effective, safe medication. Most women see a decrease in oiliness and breakouts in two to three weeks. 

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Spironolactone And Weight Gain — What’s What

Spironolactone is an oral medication sold under the brand name Aldactone and used to treat a variety of heart-related medical issues. It’s also sometimes prescribed off-label as a treatment for acne in women

While it may be an effective medication, as with any drug, spironolactone has many possible adverse effects — although it is widely considered safe to use. 

Whether or not it can cause weight gain is still up for debate. Clinical studies suggest it doesn’t and the drug’s FDA pamphlet doesn’t list weight gain as a side effect, but some women who have used the drug to treat acne anecdotally claim to have gained body weight while on spironolactone.

If you’ve tried different acne medications and none of them have been very successful, you may want to discuss spironolactone with your healthcare provider. 

12 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Hormonal Birth Control: Risk of Blood Clots. (n.d.). Michigan Medicine. Retrieved January 4, 2022, from https://www.uofmhealth.org/health-library/tw9278
  2. Turner, T., & Connolly, K. (2017, October 24). Side Effects of Drugs, Medical Devices & High-Risk Medical Conditions. Drugwatch. Retrieved from https://www.drugwatch.com/side-effects/
  3. Titus, S., & Hodge, J. (2012). Diagnosis and treatment of acne. American family physician, 86(8), 734 — 740. Available from: https://www.aafp.org/afp/2012/1015/p734.html
  4. Understanding Unapproved Use of Approved Drugs "Off Label". (2018, February 5). US Food and Drug Administration. Retrieved from https://www.fda.gov/patients/learn-about-expanded-access-and-other-treatment-options/understanding-unapproved-use-approved-drugs-label
  5. Spironolactone (Oral Route) Side Effects. (2021, July 1). Mayo Clinic. Retrieved January 5, 2022, from https://www.mayoclinic.org/drugs-supplements/spironolactone-oral-route/side-effects/drg-20071534
  6. Diuretics. (n.d.). Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/diuretics/art-20048129
  7. The Truth About Water Pills and Weight Loss. (2015, December 22). HCA Virginia Physicians. Retrieved from https://hcavirginiaphysicians.com/about/newsroom/the-truth-about-water-pills-and-weight-loss
  8. Kim, G. K., & Del Rosso, J. Q. (2012). Oral Spironolactone in Post-teenage Female Patients with Acne Vulgaris: Practical Considerations for the Clinician Based on Current Data and Clinical Experience. The Journal of clinical and aesthetic dermatology, 5(3), 37 — 50.
  9. Stubborn acne? Hormonal therapy may help. (n.d.). American Academy of Dermatology. Retrieved from https://www.aad.org/public/diseases/acne/derm-treat/hormonal-therapy
  10. Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review. (2017, February 2). NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5360829/
  11. Spironolactone. (n.d.). MedlinePlus. https://medlineplus.gov/druginfo/meds/a682627.html#other-uses
  12. Food and Drug Administration. (2018, March). ALDACTONE® (spironolactone) tablets for oral use Initial U.S. Approval: 1960. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012151s075lbl.pdf

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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