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When Is the Best Time to Take Spironolactone?

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Sian Ferguson

Published 05/21/2022

Updated 08/24/2024

If you’re using (or considering trying) spironolactone for hair loss, you might be curious about how to use it. You might be wondering, for example, when’s the best time to take spironolactone? Can you take spironolactone at night, or during the day?

The time you take spironolactone won’t impact its effectiveness. But because spironolactone can produce certain side effects, you might prefer to take it in the morning or at night, depending on which symptoms you experience.

But let’s back up a bit: Spironolactone is a prescription medication used to treat hair loss in women. While it’s considered safe and effective, it does have some potential side effects (as with all medications). 

Before you start using spironolactone, it’s a good idea to understand these side effects and consider them when deciding when to take spironolactone.

Below, we’ll discuss how to figure out the best time to take spironolactone. We’ll also briefly discuss how this medication treats hair loss.

You can take spironolactone in the morning or at night — the time doesn’t impact its effectiveness. But taking spironolactone at certain times can be more convenient for you. 

Let’s get into this below. 

Avoiding Side Effects

You might choose to take spironolactone at certain times to avoid uncomfortable side effects. 

For example, if it makes you feel a bit dizzy, you might take it at night. But if it tends to make you urinate a lot — a common side effect, as it's a diuretic — you might prefer to take it in the morning to avoid disrupting your sleep to go to the bathroom. 

You might want to experiment with different times. Try it in the morning, and if the side effects bother you during the day, try it at night. 

Remembering to Take Spironolactone 

The best time to take spironolactone — or any medication, for that matter — is when it’s easier to remember to take it. 

Spironolactone works better for hair loss when you take it consistently. You’ll want to make it as easy as possible to remember to take it so that you don’t accidentally skip doses. 

If it’s easier to remember to take your meds at night, try it then. If it’s easier to remember to take it first thing in the morning, go for it. 

Tend to be forgetful? Try setting an alarm or calendar event on your phone so that you remember to take it.

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Avoiding Drug Interactions

Spironolactone can interact with certain drugs. This means that using spironolactone with particular medications can either lower its effectiveness or cause uncomfortable side effects. 

Before a healthcare provider prescribes spironolactone, they’ll ask you about the medications you’re currently taking. It’s important to disclose any over-the-counter products, supplements, herbs, and prescription meds that are part of your routine.

Your provider may suggest that you avoid using spironolactone at the same time as other medications. For example, certain cholesterol medications — like cholestyramine — should be taken at least six hours apart from spironolactone.  

For your own safety, it’s essential that you get a medical professional’s guidance on this — and stick to their advice.

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.

Also sold under the brand name Aldactone®, spironolactone belongs to a class of drugs called aldosterone receptor antagonists.

It’s approved by the FDA to treat various medical conditions, including:

  • Hypertension (high blood pressure)

  • Hypokalemia (low potassium levels)

  • Heart failure

  • 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 treats female pattern hair loss by blocking the androgens that damage your hair follicles. The main androgen responsible for female hair loss is dihydrotestosterone (DHT), which is produced as a byproduct of testosterone.

As an anti-androgen medication, spironolactone reduces testosterone levels and prevents DHT from attaching to receptors in your scalp and harming your hair follicles.

But it doesn’t just block DHT. It also regulates your blood pressure by managing the salt and water content of your blood. 

Spironolactone acts as a diuretic (or “water pill”), causing your body to get rid of excess salt and water to reduce fluid retention. To carry out this process, it’ll cause you to urinate a higher-than-normal amount of urine.

Spironolactone is considered a potassium-sparing diuretic, though, as it makes the body retain potassium even while excreting sodium and water. 

Before using any medication, it’s important to be aware of the possible side effects. Although these side effects don’t affect everyone, it’s worth keeping these in mind as you decide when to take spironolactone.

Common side effects include:

  • Drowsiness

  • Frequent urination

  • Headaches

  • Nausea

  • Lightheadedness and dizziness

  • High levels of potassium 

Since spironolactone is a diuretic, it can make you pee more frequently than you’re used to. 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 experience side effects like dizziness or drowsiness, 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. This means you take half your dose at night and half in the morning.

In any case, it’s crucial to closely follow your healthcare provider’s instructions and use spironolactone only as prescribed.

It’s especially important to get help if you think you’re experiencing any serious side effects of spironolactone, like: 

  • Dehydration

  • Allergic reactions 

  • Fast or irregular heartbeat (caused by high potassium levels)

  • Gastrointestinal issues

  • Low sodium levels, causing muscle weakness

  • Changes in sex drive

  • Trouble breathing

  • Kidney problems

A healthcare professional might order blood tests to determine whether spironolactone is causing any adverse effects, such as high levels of potassium or kidney disease.

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Although you can technically take spironolactone at any time, it’s important to consider the following points to ensure you’re taking it safely.

When using spironolactone:

  • 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 — whichever is your preference. There are also certain foods to avoid with spironolactone, as they may cause high potassium levels. Make sure to be aware of these foods.

  • 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 adjust your dosage only as prescribed.

  • If you use other medications or supplements, inform your provider. Certain medications, especially potassium supplements and potassium-containing salt substitutes, 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 to avoid becoming dehydrated.

  • Limit or avoid alcohol. You may also want to limit or cut out your alcohol intake. Combining alcohol and spironolactone can lead to dangerously low blood pressure and other serious side effects.

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.

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. 

Bear in mind there can be serious drug interactions between spironolactone and other medications, including:

  • Non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin, naproxen, 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. 

Hair Regrowth

The long, short, thick, and thin of it

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: 

  • There’s no one best time of day to take spironolactone. The most important thing is to take it consistently at a time that is convenient for you.

  • You might want to take it at a certain time to avoid side effects. If it makes you urinate constantly, it could be best to take it during the day. If it makes you drowsy, it might be better to take it at night. 

  • It’s important to stick to your healthcare provider’s instructions. They might suggest taking it at a certain time to avoid drug interactions. 

If spironolactone isn’t working for you, the good news is that there are other promising hair loss treatments. For example, you could try our minoxidil solution or minoxidil foam. For postmenopausal hair loss, our topical finasteride and minoxidil spray could be a great choice.  

Concerned about hair loss? Not sure which treatment to look into? Start an online consultation with a licensed healthcare professional to discuss current hair loss treatments.

5 Sources

  1. American Academy of Dermatology Association. (n.d.). Hair Loss: Diagnosis and Treatment. Retrieved August 19, 2023, from https://www.aad.org/public/diseases/hair-loss/treatment/diagnosis-treat
  2. Common questions about spironolactone. (2022). https://www.nhs.uk/medicines/spironolactone/common-questions-about-spironolactone/
  3. HIGHLIGHTS OF PRESCRIBING INFORMATION: ALDACTONE® (spironolactone) tablets for oral use. (n.d.-c). https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/012151s075lbl.pdf
  4. Patibandla S, et al. (2023). Spironolactone. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554421/
  5. Wang C, et al. (2023). The Efficacy and Safety of Oral and Topical Spironolactone in Androgenetic Alopecia Treatment: A Systematic Review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010138/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board-certified dermatologist specializing in hair loss. Dr. Beasley obtained his Bachelor of Science from the United States Military Academy at West Point, NY, and he subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA.

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military in San Antonio, TX, helping to diagnose dermatologic conditions in soldiers all over the world. Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen, of course) with his wife and two children in his spare time.

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