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Modern medicine is pretty great. We have various medications to treat all sorts of medical conditions, and many also pull double-duty as off-label drugs to treat other health issues.
Take spironolactone, for instance. Like many prescription drugs, spironolactone is prescribed off-label to treat conditions other than those for which it’s approved by the FDA — namely, hair loss in women and hormonal acne.
While a multipurpose medication can be great, there are some things to know if you’re currently taking (or thinking about starting) this particular drug — like what foods to avoid while taking spironolactone.
You might be desperately wondering, Can I eat potatoes on spironolactone? What about cheese?!
We’ll explain what foods to avoid on spironolactone below. We’ll also talk a bit about what spironolactone is and how it works as a medication for acne breakouts, female pattern baldness and other medical conditions.
Before we dive into spironolactone foods to avoid, let’s first talk about what spironolactone is (and why you might need to avoid certain foods).
Spironolactone (also sold under the brand name Aldactone®) is a prescription medication belonging to a class of drugs called aldosterone receptor antagonists.
It’s approved to treat hypertension (high blood pressure), low levels of potassium (hypokalemia), heart failure, edema (excessive swelling) and high levels of the hormone aldosterone (hyperaldosteronism).
Off-label, though, spironolactone is commonly used to treat hair loss in women. It’s also sometimes used as an acne treatment for breakouts caused by hormonal health issues.
How does spironolactone for hair loss and acne work, though? What about when it’s used to treat other medical conditions?
Spironolactone works by blocking the effects of the hormone aldosterone. This helps regulate blood pressure by managing the salt and water content of your blood and promoting the excretion of the electrolyte potassium.
Also acting as a diuretic medication (aka “water pill”), spironolactone causes your body to expel excess salt and water, which reduces fluid retention.
But we should note that spironolactone is a potassium-sparing diuretic because it causes the body to retain potassium even as it secretes sodium and water.
Many androgen hormones can also cause acne, including the breakouts you may notice before and during your period.
As an antiandrogen medication, spironolactone reduces testosterone levels. This helps prevent DHT from attaching to receptors in your scalp and harming your hair follicles or producing more sebum for acne. Thanks to its effects on DHT levels, spironolactone is often used to treat female pattern hair loss.
Now that you understand the relationship between spironolactone and potassium levels, know this: Certain foods may increase the medication’s side effects, cause adverse effects or pose serious risks when taking this medication — namely, potassium-rich foods.
Want to know what foods to avoid while taking spironolactone?
Potassium-rich foods include:
Many common fruits, such as plums (and the dried version, prunes), apricots, bananas, grapefruit, apples, oranges, grapes (and raisins), avocados, cantaloupe and squash
Leafy green vegetables, like broccoli, spinach, collard greens and asparagus
Many types of beans and legumes, such as kidney beans, soybeans and lentils
Some types of meat, seafood and poultry, including chicken breast, salmon, beef and turkey
Root vegetables, like potatoes and carrots
You may not need to completely avoid these foods while using spironolactone. However, it’s crucial to talk to your healthcare provider about your diet before you use this medication for hair loss, acne or any other medical condition.
They 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 foods to avoid on spironolactone, some supplements, food substitutes and medications may contribute to high blood potassium levels when used with spironolactone.
Potassium supplements. Potassium supplements — including over-the-counter supplements for treating high blood pressure 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 or drug information of your existing dietary supplements (including electrolyte drink mixes) 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.
Non-steroidal anti-inflammatory drugs (NSAIDs). Using an over-the-counter NSAID like aspirin or ibuprofen to relieve pain or reduce inflammation while taking spironolactone can reduce its diuretic effects. Taking NSAIDs along with spironolactone has also been associated with severe hyperkalemia (high potassium levels).
Several common types of prescription drugs — including beta-blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers — may also have drug interactions with spironolactone and contribute to elevated potassium levels when used with the medication.
Now you know what foods to avoid while taking spironolactone — but what about certain beverages, namely spironolactone and alcohol?
When seeking medical advice from your healthcare provider, they’ll give you the best instructions on drinking while taking your medication. But you should know that the combination of spironolactone and alcohol can increase certain side effects of spironolactone like increased dizziness, lightheadedness and fainting.
One more thing, not food-related: There’s no strong connection between spironolactone and weight gain, as the drug acts as a diuretic that gets rid of excess salt and water in your body.
When taking any medication, it’s always good to know everything about that drug, including what (if any) foods to avoid. This goes for spironolactone, a common treatment for hair loss in women and acne.
Here’s what to keep in mind:
Spironolactone is approved by the FDA to treat high blood pressure, low potassium levels, excessive swelling and more. It’s also prescribed off-label for the treatment of female pattern hair loss and hormonal acne.
To treat hair loss and acne, spironolactone (an antiandrogen medication) reduces testosterone levels and prevents the androgen hormone DHT from harming your hair follicles or producing more sebum for acne.
Due to its effects on potassium levels, certain foods to avoid on spironolactone include common fruits, leafy green vegetables, some types of meat and root vegetables. You may also need to avoid potassium supplements, electrolyte drinks or NSAIDs like ibuprofen.
Seek medical advice from your healthcare provider if you experience any uncomfortable side effects of spironolactone, have kidney problems, are breastfeeding or have other concerns about the medication.
Spironolactone is just one option to stimulate hair growth in women.
To explore your options, talk to a healthcare professional about other hair loss treatments and medications — many of which are FDA-approved with minimal side effects.
These include minoxidil — available as minoxidil drops or oral minoxidil medication — and finasteride. You might also consider this two-in-one topical finasteride and minoxidil spray for postmenopausal women.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
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