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Two lies about getting older: You no longer have to deal with acne, and hair loss is reserved for the boys’ club. The unfortunate truth is that many of us contend with hormonal acne well past our teen years, and hair loss in women is an all too common occurrence.
On the much more positive side, there are several ways to treat acne and hair loss (hooray, modern medicine). One option is spironolactone, an easy-to-use medication.
If you’ve noticed a widening part or thinning hair, your healthcare provider or dermatologist may prescribe spironolactone for hair loss.
Let’s say you want to maximize the full benefits of this medication. You might be wondering about the best time to take spironolactone. Can you take spironolactone at night, or should it be during the day?
We’ll explain how to take spironolactone, as well as how this medication treats hair loss.
Before we tell you when to take spironolactone (we’ll get there, we promise!), allow us to explain what this medication does.
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 by the FDA (U.S. Food and Drug Administration) to treat various medical conditions, including:
Hypertension (high blood pressure)
Hypokalemia (low potassium levels)
Edema (excessive swelling)
Hyperaldosteronism (high levels of the hormone aldosterone)
Off-label, spironolactone is an effective hair loss treatment for women. It’s so effective for hair loss, in fact, that a study published in the Journal of the American Academy of Dermatology found that a majority of women saw hair growth after six months with an average 100-milligram dose of spironolactone.
Spironolactone mainly works in two ways.
First, it blocks the effects of the hormone aldosterone. This regulates your blood pressure by managing the salt and water content of your blood and promoting the excretion of potassium.
Second, it acts as a diuretic (or “water pill”), causing your body to get rid of excess salt and water to reduce fluid retention. Spironolactone is considered a potassium-sparing diuretic, though, as it makes the body retain potassium even while excreting sodium and water.
As an antiandrogen medication, spironolactone reduces testosterone levels and prevents DHT from attaching to receptors in your scalp and harming your hair follicles.
So, when is the best time to take spironolactone? Maybe you’re wondering, Can I take spironolactone at night?
Spironolactone is usually prescribed for use one to two times per day, with an average dose of 100 to 200 milligrams to treat female pattern hair loss.
As for when to take spironolactone, there’s no specific time of day to take spironolactone for hair loss. In other words, you can use it at any time you like.
For many, the best time of the day to take spironolactone is when you remember.
Since spironolactone is a diuretic, it can make you need to pee more often than normal. For this reason, you might want to take your dose of spironolactone in the morning to avoid having to wake up during the night to go to the bathroom.
On the other hand, if you frequently develop any of the possible side effects of spironolactone — such as dizziness, nausea or lightheadedness — it’s okay to take your medication before you go to bed. That way, these issues will have less of an impact on your daily life.
If you experience persistent or serious side effects, your healthcare provider may suggest taking a split dose of spironolactone. In any case, it’s crucial to closely follow your healthcare provider’s instructions and use spironolactone only as prescribed.
Regardless of the best time to take spironolactone, it’s important to be consistent with your use. This means that if you generally take your medication in the morning, you should continue to take it around the same time every day.
You should also make sure to:
Take spironolactone with or without food consistently. Food can affect the speed at which your body absorbs spironolactone, so take your medication either with or without food each time. There are also certain foods to avoid with spironolactone that may cause high potassium levels.
Follow your dosage instructions. Your healthcare provider may give you a low dose of spironolactone to start, then adjust your daily dose over time. Always follow their instructions and, if necessary, adjust your dosage as prescribed.
If you use other medications or supplements, inform your provider. You might need to make changes to your use of other medicines while using spironolactone, especially those that can cause drug interactions. Potassium supplements and potassium-containing salt substitutes, for instance, can significantly increase your risk of developing hyperkalemia while using spironolactone.
Drink plenty of water while taking spironolactone. As a potassium-sparing diuretic, spironolactone can make you pee more frequently than usual. Try to drink lots of water while using Aldactone to avoid becoming dehydrated.
Limit or avoid alcohol. You may also want to limit the amount of alcoholic beverages you drink or cut out booze entirely. Combining alcohol and spironolactone can increase serious side effects of spironolactone, like dizziness, lightheadedness, fainting or trouble breathing.
If you miss a dose, take it as soon as you remember — unless it’s almost time for your next dose. In that case, skip the missed dose and just take your next scheduled dose.
There’s a chance you’ll experience common side effects of spironolactone, such as:
High potassium level resulting in a fast or irregular heartbeat
Low sodium levels, causing muscle weakness
Spironolactone generally appears safe to take while breastfeeding. However, you should seek medical advice from your healthcare provider if you’re currently breastfeeding before starting treatment with spironolactone.
This medication also seems to be safe for those with kidney disease, nephrotic syndrome and other kidney problems — though patients should always be closely monitored by a healthcare professional.
Bear in mind there can be serious drug interactions between spironolactone and other medications, including:
Non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin or ibuprofen
ACE (angiotensin-converting enzyme) inhibitors that relax blood vessels to lower blood pressure
Lithium medications used for mood disorders
Digoxin (heart failure medication)
If you’re taking prescription medication for heart disease, Addison’s disease, liver disease or any other medical conditions, be sure to let your provider know.
When dealing with hair loss, you have multiple options, including spironolactone, a common hair loss and acne treatment for women.
Here’s what to keep in mind:
Spironolactone is an FDA-approved medication used to treat several conditions, such as high blood pressure, low potassium levels, swelling and heart failure. This drug can also be used off-label to treat hair loss in women.
As a hair loss medication, spironolactone works by reducing the body’s production of androgen hormones that cause hair to thin and shed.
There’s no one best time of the day to take spironolactone. Your healthcare provider may suggest taking it in the morning, before going to bed or at another time that’s convenient for you.
Other medications for female hair loss include minoxidil, available as a topical solution in minoxidil drops or minoxidil foam, as well as oral minoxidil tablets. There’s also a combination topical finasteride and minoxidil spray for treating postmenopausal hair loss.
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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