What Foods Should be Avoided When Taking Spironolactone?

Before using a new medication, it’s important to understand the potential side effects and any safety precautions you need to take. If you’re thinking about taking spironolactone, you’ll also want to know which foods to avoid while on the medication.

As far as medicines go, spironolactone is something of a Swiss army knife: It’s used for a wide range of issues, such as heart disease, hair loss in women, and acne caused by hormonal imbalances.

Also sold under the brand name Aldactone®, spironolactone is pretty safe. But, as with all medications, it has some potential side effects.

Some of spironolactone’s side effects can be worsened by your diet — specifically, a diet high in potassium.

Below, we’ll explain what foods to avoid on spironolactone and explore how the medication works for acne breakouts, female pattern baldness and other medical conditions.

Spironolactone is a potassium-sparing diuretic (water pill). It causes your body to hold onto an electrolyte called potassium even as it secretes sodium and water (that is, by making you urinate more often).

This is useful when it comes to treating low potassium levels (hypokalemia). But if your potassium levels get to the point where they’re way too high — a condition called hyperkalemia — it can be dangerous.

So, you’ll want to avoid excessive amounts of potassium-rich foods. You should also avoid foods that are high in salt.

If you’re on spironolactone, foods to avoid include:

• Avocados

• Bananas

• Carrot juice

• Prune juice

• Potatoes with skin

• Leafy greens

• Orange juice

• Kiwi

• Clams

• Very salty foods

This doesn’t mean you should completely avoid all of these foods. You can still enjoy the occasional avocado toast and your mom’s roast potatoes — just do so sparingly.

And, importantly, be on the lookout for the signs and symptoms of high potassium levels. The signs include:

• Irregular heartbeat

• Muscle weakness

• Drowsiness and fatigue

• Confusion

• Nausea and vomiting

When left untreated, high potassium levels can lead to adverse effects like kidney disease, heart failure, and heart attacks. If you think your potassium levels are hitting high levels while on the medication,  go straight to the emergency room.

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. These include over-the-counter supplements for treating high blood pressure formulated with potassium.

• Electrolyte drink mixes that contain sodium and potassium. These can lead to high levels of sodium and potassium when used with potassium.

• 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). Over-the-counter NSAIDs like aspirin or ibuprofen can reduce spironolactone’s diuretic effects. They can also lead to high potassium levels.

• Excessive amounts of alcohol. Combining spironolactone and alcohol can lead to uncomfortable side effects, including dizziness, low blood pressure, and confusion — especially if you consume a lot of alcohol. Avoid alcohol, or limit yourself to one drink a day maximum.

Spironolactone can also interact with certain medications. Double-check with your doctor before using prescription drugs like:

• ACE inhibitors

• Angiotensin receptor blockers

• Beta-blockers

• Digoxin

• Lithium

• Other potassium-sparing diuretics, like eplerenone

If you currently use a potassium supplement or any prescription medication, tell your healthcare provider before using spironolactone. Some drug interactions can be serious.

Don’t go off medication suddenly without your medical provider’s advice. Instead, get in touch with your provider and follow their recommendations.

Some people wonder if spironolactone can lead to weight gain. 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.

So, spironolactone shouldn’t be combined with certain foods and supplements — but why?

In order to understand the risks and side effects of spironolactone better, it’ll be helpful to get an overview of how it works.

Spironolactone belongs to a class of drugs called aldosterone receptor antagonists. By blocking the hormone aldosterone, the medication causes extra fluid to leave the body without lowering your potassium levels.

The Food and Drug Administration (FDA) has approved spironolactone for the treatment of:

• Edema (fluid retention), especially caused by liver disease or kidney disease

• Heart failure

• Hypertension (high blood pressure)

• Hypokalemia (low potassium levels)

Spironolactone also blocks certain male hormones, like testosterone, from working properly. For that reason, it’s used off-label to treat:

• Female pattern hair loss

• Hormonal acne in women

• Hirsutism (excess body hair)

People use spironolactone for hair loss because female hair loss can be caused by the hormone dihydrotestosterone (DHT), an androgen produced as a byproduct of testosterone. Likewise, androgen hormones can cause hormonal acne.

Because spironolactone is an anti-androgen medication, it can reduce these unwanted effects of male hormones.

However, as with all medications, spironolactone does have side effects. Other than high potassium levels, it can also cause:

• Allergic reactions (if you’re allergic to it)

• Breast pain or breast enlargement

• Changes in body hair growth

• Changes in motor control

• Dehydration

• Dizziness

• Drowsiness or fatigue

• Electrolyte imbalances

• Frequent urination

• Headaches

• Hyperaldosteronism (high levels of the hormone aldosterone)

• Low blood pressure

• Menstrual cycle changes

• Nausea, vomiting, and diarrhea

• Postmenopausal vaginal bleeding

• Restlessness

• Stomach cramps or pain

Plus, it blocks the effects of testosterone — which can sometimes cause unwanted feminization in men. For example, it can cause gynecomastia, which is enlarging breast gland tissue in men.

Although this list is pretty long, spironolactone is generally considered a safe medication — as long as you use the correct dose as advised by your healthcare provider.

If you have any noticeable symptoms, reach out to a medical professional for advice. They may run blood tests to check your potassium levels.

Although there’s no special spironolactone diet you’ll need to follow, you’ll want to be mindful that excessive amounts of some foods can be pretty dangerous. This is because spironolactone can cause dangerously high levels of potassium.

Here’s what to keep in mind:

• Spironolactone increases your potassium levels. This can be good if you have low levels of potassium, but there are risks: very high potassium levels can be dangerous.

• Avoid consuming a lot of potassium-rich foods. This includes foods like bananas, prune juice, and clams. You don’t have to make major dietary changes — just avoid indulging in those foods too often.

• There are other things you should avoid. Potassium-rich electrolyte drinks, potassium supplements, and NSAIDs like ibuprofen aren’t safe to use with spironolactone. Clear it with your healthcare provider before taking it.

Please 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 medication for hair loss in women — if it’s not working for you, there are other treatments available. Talk to a healthcare professional about exploring other hair loss treatments.

If you want to get started with an online hair consultation, start by taking our hair quiz.