Medically reviewed by Jill Johnson, FNP
Written by Our Editorial Team
Last updated 6/13/2022
Spironolactone works by reducing the effects of androgens — male sex hormones that can bind to receptors in your skin and damage your hair follicles. When it’s used consistently, it can slow down the effects of hair loss and even help you to regrow hair.
Like other medications, spironolactone can interact with certain drugs and substances, including some potassium-rich foods. It’s important to avoid these foods while you’re using spironolactone — a task that may require making a few adjustments to your diet.
Below, we’ve explained what spironolactone is, as well as how it works as a medication for acne breakouts, female pattern hair loss and other medical conditions.
We’ve also explained what foods should be either avoided or limited when taking spironolactone and shared a few simple tips that you can use to stay safe while using this medication.
Congestive heart failure
Hypertension (high blood pressure)
Primary hyperaldosteronism (high levels of the hormone aldosterone)
Hypokalemia (low levels of potassium)
Edema (excessive swelling)
Like many other medications, spironolactone is also prescribed off-label to treat conditions other than those for which it’s approved by the FDA. More specifically, it’s commonly used to treat hair loss in women, as well as acne breakouts caused by hormonal health issues.
Spironolactone has several effects on your body. First, it works by blocking the effects of the hormone aldosterone, which is involved in regulating your blood pressure by managing the salt and water content of your blood, as well as by promoting the excretion of potassium.
Because of its effects on water reabsorption into your bloodstream, spironolactone also acts as a diuretic medication, or a “water pill.” Put simply, it causes your body to expel excess salt and water, which reduces fluid retention.
Unlike other diuretics, which usually reduce potassium levels, spironolactone is referred to as a potassium-sparing diuretic. This is because it causes your body to retain potassium even as it’s secreting sodium and water.
So, what does this have to do with hair loss? Just like male pattern hair loss, pattern hair loss in women is caused by the effects of the hormone dihydrotestosterone (DHT), an androgen that’s produced as a byproduct of testosterone.
DHT can attach to receptors in your scalp and harm your hair follicles, causing diffuse hair loss to develop. Because of the role of androgens in this type of hair loss, it’s sometimes referred to as androgenetic alopecia.
As an antiandrogen medication, spironolactone reduces testosterone levels and prevents DHT from attaching to receptors in your scalp and harming your hair follicles. Thanks to its effects on DHT levels, spironolactone is often used to treat female pattern hair loss.
In fact, we offer spironolactone for hair loss as part of our range of medications for treating and preventing women’s hair loss.
Spironolactone is a convenient, effective and safe effective medication for most people when it’s used as prescribed. However, like other medications, spironolactone can potentially interact with other drugs.
Due to its effects on potassium levels, spironolactone can also cause adverse effects and safety risks when it’s used with foods that contain a high level of potassium.
Foods rich in potassium include:
Many common fruits, including plums and prunes, apricots, bananas, grapefruits, apples, oranges, grapes and raisins, avocados, cantaloupes, squash and others.
Leafy green vegetables, including broccoli, spinach, collard greens and asparagus.
Many types of beans and legumes, including kidney beans, soybeans and lentils.
Some types of meat, seafood and poultry, including chicken breast, salmon, beef and turkey.
Root vegetables, including potatoes and carrots.
You may not need to completely avoid these foods while you use spironolactone. However, it’s important to talk to your healthcare provider about your diet before you use this medication for hair loss, acne or any other condition.
Your healthcare provider may recommend limiting your intake of certain foods or making other adjustments to your diet to reduce your total potassium intake while using spironolactone.
In addition to certain foods and cooking ingredients, some supplements, food substitutes and medications may contribute to high blood potassium levels when used with spironolactone.
Potassium supplements. Potassium supplements, including supplements for treating high blood pressure that are formulated with potassium, can significantly increase your risk of developing hyperkalemia while using spironolactone.
If you currently use a potassium supplement, tell your healthcare provider before using spironolactone. Check the nutrition labels of your existing dietary supplements to see if any of them contain potassium.
Potassium-containing salt substitutes. Some salt substitutes marketed as “lite” salt and “low-sodium” salt alternatives contain potassium chloride and should not be used with spironolactone.
Several common types of medications, including beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, may contribute to elevated potassium levels when used with spironolactone.
Other over-the-counter and prescription medications may also affect spironolactone and cause an elevated risk of side effects or safety issues.
Make sure to inform your healthcare provider about any medications, dietary supplements and other health products you currently use or have recently used before you begin treatment with spironolactone.
While using spironolactone, your healthcare provider may ask you to get regular blood tests to check your potassium levels and kidney function. Make sure to closely follow your healthcare provider’s instructions and complete any routine tests required during treatment.
When it’s used as prescribed, spironolactone can be a safe and effective medication for female pattern hair loss, acne and other issues.
However, because of its effects on potassium levels, you may need to make some adjustments to your diet while using this medication. For most people, these changes are minor and easy to manage.
You can also learn more about how spironolactone works, its potential side effects, answers to frequently asked questions and more in our detailed guide to spironolactone.