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How Much Water Should I Drink When Taking Spironolactone?

Vicky Davis, FNP

Medically reviewed by Vicky Davis, FNP

Written by Our Editorial Team

Last updated 2/10/2022

Medications can do a lot for us, but these days it seems that the more obscure a medication’s name sounds to the average person, the more “quirky” the side effects may be. 

The medical community has many treatment options and modalities for what ails you — yet some of them may just come at a price. 

Such is the case with spironolactone: a daily diuretic known to help people with blood pressure, kidney disease, liver disease, and certain skin and hair issues, including patterned hair loss. 

If you’ve been prescribed this medication, or are considering taking it, you’ve likely come across information about one of its more common side effects: dehydration. 

Dehydration may sound like a simple side effect to counteract, but can you just drink more water when taking spironolactone? The answer depends on several factors, starting with why you’re taking it.  

Read on to learn more about how your water intake could help.

What Is Spironolactone and What Does It Do?

Spironolactone is a prescription drug used to treat a variety of problems including low potassium levels, heart failure, and edema (also known as water weight gain or fluid retention) as caused by diseases of the liver or kidney.​​ 

In some cases, it can be used alone or with other medications as a blood pressure treatment. Spironolactone can also be used to help the body regulate the hormone aldosterone, which in excess can cause hyperaldosteronism.

Spironolactone blocks aldosterone receptors, which in effect blocks sodium reabsorption, and increases retention of potassium. This medication is sometimes used for the treatment of acne vulgaris, where it can reduce sebum production. This, along with its sometimes-mentioned ability to help female patients reduce abnormal facial hair, make it something of a rarely used tool in the skincare world.

In certain cases, too, spironolactone may (according to studies) be an effective treatment for patterned hair loss in women.

Arguably the most common of the applications for spironolactone is for the regulation of high blood pressure, which when left untreated can lead to heart attack or stroke, kidney failure, loss of vision and more. 

Typically, doctors who prescribe spironolactone for this and other conditions advise patients to make complementary changes to their lifestyle. That means, eating a diet lower in fat and salt, maintaining a healthy weight, exercising, quitting smoking and moderating alcohol consumption.

Spironolactone comes in a tablet or liquid form, and is taken orally once or twice a day.

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Side Effects of Spironolactone

Spironolactone is a powerful drug, and with that comes some potential for serious side effects, some of which do affect your hydration.

Common side effects of spironolactone include a variety of stomach issues. These include diarrhea, vomiting, stomach cramps, leg cramps, muscle cramps or other muscle pains, as well as nausea, lack of appetite and lack of energy.

Vaginal bleeding after menopause, irregular menstrual periods and breast swelling or breast pain for both men and women have been reported, as well as deepening of voice, increased body hair growth, pain, burning and some flu-like symptoms.

Certain medications including salt substitutes or water pills may have adverse effects if taken alongside spironolactone.

Contact a healthcare provider immediately and request medical attention if you experience an inability to move your arms and legs, numbness or tingling, yellowing of the skin or eyes, difficulty breathing or swallowing, rash, hives or itching, or confusion, unusual bleeding, blood in the stool or bruising.

As for the question of hydration, spironolactone can cause dry mouth, thirst, headache and other signs of dehydration, as well as decreased urination and fainting. That’s a long list — and one that might make you wonder if you should drink extra water when taking this medication.

Should You Drink Extra Water When Taking Spironolactone?

Your hydration level when taking spironolactone is important, and because the medication is a diuretic, you’ll want to let your doctor know if you’re taking other diuretic medications, or medications that may cause dehydration.

In addition to cutting down on your sodium and alcohol intake, you should be cautious of kidney function and liver issues and share your medical history with a healthcare provider before taking this medication. You’ll also need to let your provider know if you’re pregnant.

Drinking water to combat the effects of dehydration is certainly recommended; you should make sure you’re drinking enough water each day regardless of whether you’re taking a diuretic medication, but especially in situations where dehydration can increase the risks of side effects like fainting.

As with any other side effect, dehydration is not guaranteed, so it’s not necessarily the case that you should be immediately increasing your water intake. The appropriate response is to follow the orders of a healthcare provider, monitor for signs of dehydration and share that information with your healthcare professional when you see them. 

They may recommend you drink more water, or may respond with other modifications to the medication or your lifestyle.

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Spironolactone, Hair Loss and Your Health: The Big Picture

If you’ve been prescribed spironolactone for hair loss, taking it under medical advice is not something to worry about. Whether it’s for heart disease or something less serious, this medication is generally considered safe and effective when taken as directed — and when avoiding dangerous drug interactions. 

You may never become dehydrated while taking spironolactone, but that is no reason not to be cautious. (It’s also a good idea to make sure you’re properly hydrated for general health.)

As for your hair loss, we can’t advise whether this medication will help you solve ongoing pattern hair loss problems. Your hair health is best left to a healthcare professional with the right experience to help you prevent further damage and maintain the hair you have. 

There are other options for treating hair loss, too.  

The topical agent minoxidil increases blood flow to hair follicles, which can encourage growth, and according to one study on patients with alopecia areata, it can boost hair growth by 18 percent. 

Herbal options for treating hair loss may help you retain volume and follicles. Saw palmetto is a popular natural ingredient for controlling the hair-killing hormone DHT, and may help if you’re dealing with hormonal hair loss. 

Vitamin deficiencies can cause a number of problems too, and these can be addressed with the proper supplements (like our Biotin Gummy Multivitamins).

This information, however, assumes a lot about your predicament. If you’re dealing with sudden hair loss, talking with a healthcare provider immediately is the smartest thing you can do.

Whatever is ailing your hair, there are options available. Have a glass of water, take a deep breath, and then take the next step. The sooner you act, the more you can do to maintain and regain the full head of hair you love.

5 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. Suchonwanit, P., Thammarucha, S., & Leerunyakul, K. (2019). Minoxidil and its use in hair disorders: a review. Drug design, development and therapy, 13, 2777–2786. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/.
  2. Marks, L. S., Hess, D. L., Dorey, F. J., Luz Macairan, M., Cruz Santos, P. B., & Tyler, V. E. (2001). Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens. Urology, 57(5), 999–1005. https://pubmed.ncbi.nlm.nih.gov/11337315/.
  3. U.S. National Library of Medicine. (n.d.). Spironolactone: Medlineplus drug information. MedlinePlus. Retrieved January 10, 2022, from https://medlineplus.gov/druginfo/meds/a682627.html.
  4. Patibandla S, Heaton J, Kyaw H. Spironolactone. Updated 2021 Jul 18. In: StatPearls Internet. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554421/.
  5. Rathnayake, D., & Sinclair, R. (2010). Innovative use of spironolactone as an antiandrogen in the treatment of female pattern hair loss. Dermatologic clinics, 28(3), 611–618. https://pubmed.ncbi.nlm.nih.gov/20510769/.

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. Learn more about our editorial standards here.

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