Medically reviewed by Leah Millheiser, MD
Written by Our Editorial Team
Last updated 5/13/2020
The lists of side effects rattled off on television commercials for prescription drugs can be laughable — they’re the inspiration for many memes and Saturday Night Live skits.
But when you experience these unpleasant side effects, the joke suddenly stops.
As with other prescription drugs, spironolactone comes with a lengthy list of potential side effects.
However, just because these effects are possible doesn’t make them all likely. But knowing what you risk by taking spironolactone may help you make a better-informed decision about whether it’s right for you.
Spironolactone is a prescription medication approved by the FDA to treat edema, congestive heart failure, high blood pressure and hyperaldosteronism.
It is also used off-label in the treatment of acne in women.
The most common side effect experienced among men on spironolactone is gynecomastia, or the enlargement of the breast tissue.
As with all prescription drugs, the use of spironolactone should be decided after close discussion with a healthcare provider about the benefits versus risks.
Spironolactone is a prescription drug sometimes sold under the brand names Aldactone® and Carospir®.
It is known as an aldosterone antagonist, which means it reduces the effect of aldosterone within the body.
Aldosterone is a hormone produced by the adrenal gland that plays a role in cardiovascular and renal health.
Spironolactone is approved by the Food and Drug Administration to treat several conditions, but is also used “off-label” for the treatment of acne in women.
“Off-label” means that the FDA has not specifically approved spironolactone for the treatment of acne, although it is frequently used for this purpose in dermatologic healthcare.
According to the drug’s label, spironolactone is used to treat:
Hyperaldosteronism (when the body produces too much aldosterone), resulting in low potassium levels
Hypertension, or high blood pressure
Edema or fluid retention
As with all prescription drugs, using spironolactone comes with risks of side effects. Because the drug alters the hormone balance within your body, many of the side effects are hormonal in nature.
For men: The most common side effect of spironolactone is gynecomastia, or the enlargement of breast tissue in men, according to the drug’s manufacturer. In men, the drug may also cause erectile dysfunction.
Additional possible side effects of spironolactone include:
Stomach ache and cramping
Rare, but serious possible side effects include:
Changes in heartbeat
Muscle pain, weakness, and cramping
Signs of dehydration
Difficulty breathing or swallowing
Rash, hives and/or itching
Bloody stools or vomit
Unusual bruising or bleeding
If you experience serious side effects while taking spironolactone, contact your healthcare provider for medical advice immediately.
Some drugs must not be taken with spironolactone due to the risk of adverse effects. Your healthcare provider will help you determine if the medications you’re on can cause an interaction.
Make sure you tell your them about everything you take, both prescription and over-the-counter, as even potassium supplements may interfere with spironolactone.
The following are a sampling of medications that should be avoided while taking spironolactone:
Drugs designed to increase potassium levels
Non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen and naproxen
Editor’s note: while the above medications may, in some circumstances, be taken while under the supervision of a healthcare provider, eplerenone can never be taken while using spironolactone.
Some people should not take spironolactone, including those with Addison’s disease or hyperkalemia.
Drinking alcohol while on spironolactone can cause exaggerated effects like dizziness, but also lightheadedness and fainting upon standing. If you drink regularly, tell your healthcare provider before beginning spironolactone.
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