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When Should You Take Spironolactone?

Angela Sheddan

Medically reviewed by Angela Sheddan, FNP

Written by Our Editorial Team

Last updated 5/22/2022

If you have female pattern hair loss, your healthcare provider may prescribe the antiandrogen medication spironolactone.

Research shows that spironolactone can help to slow down or stop hair loss in women. It’s an easy-to-use, convenient medication that’s available in tablet form, making it a quick and simple addition to your hair care routine.

So, when should you take spironolactone? Spironolactone is typically prescribed for use one to two times per day. There’s no precise time of day to take spironolactone, but it’s best to stick to a regular schedule to make sure levels of the medication remain steady in your body.

Below, we’ve gone into more detail about what spironolactone is, how it works as a medication for female hair loss, as well as what you should know about using spironolactone. 

What Is Spironolactone?

Spironolactone is a prescription medication that belongs to a class of drugs called aldosterone receptor antagonists. It works as a diuretic (a water pill, or medication that helps the kidneys to remove extra water from your body).

Spironolactone is approved by the FDA to treat a variety of conditions, including

  • Low potassium levels

  • Hyperaldosteronism (high aldosterone levels)

  • Hypertension (high blood pressure)

  • Edema (fluid retention)

  • Congestive heart failure

Like many other prescription medications, spironolactone is also used off-label as a treatment for various other conditions. 

One of these conditions is female pattern hair loss, or androgenetic alopecia. As well as helping the body to expel water, spironolactone has antiandrogen effects, meaning it can lower levels of androgen hormones in the body.

Because female pattern hair loss is caused by androgen hormones such as dihydrotestosterone (DHT), the antiandrogen effects of spironolactone can help to reduce the severity of female hair loss, and in some cases, even restore hair growth.

Our guide to spironolactone goes into more detail about how spironolactone works, its potential side effects and more. 

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When to Take Spironolactone

Spironolactone is usually prescribed for use one to two times per day. If you use spironolactone to treat female pattern hair loss, you’ll typically need to take one tablet per day, with a total daily dosage of 100mg to 200mg per day of spironolactone. 

As an antiandrogen medication, spironolactone works by reducing your levels of hormones that can either cause or contribute to female pattern hair loss. 

As for when to take spironolactone, there’s no specific time of day to take spironolactone for hair loss, meaning you can use it at any time you like.

Because spironolactone is a diuretic, it can make you need to pee more often than normal. You may want to take your dose of spironolactone in the morning to avoid having to wake up during the night to go to the toilet. 

On the other hand, if you frequently develop side effects from spironolactone, such as dizziness, nausea or lightheadedness, it’s okay to take your medication before you go to bed so that these issues have less of an impact on your quality of life.

If you get persistent side effects from spironolactone, your healthcare provider may suggest that you take a split dose of spironolactone. It’s important to closely follow your healthcare provider’s instructions and use spironolactone only as prescribed. 

Regardless of what time of day you use spironolactone, it’s important to be consistent with your use of this medication. This means that if you generally take spironolactone in the morning, you should continue to take the medication at around the same time every day.

You should also make sure to:

  • Take spironolactone with or without food on a consistent basis. Food can affect the speed at which your body absorbs spironolactone. Take spironolactone consistently with or without food each time.

  • Follow your dosage instructions. Your healthcare provider may give you a low dose of spironolactone to begin with, then adjust your daily dose over time. Make sure to follow your healthcare provider’s and, if necessary, adjust your dosage as prescribed.

  • If you also use other medications, inform your healthcare provider. You might need to make changes to your use of other medications while using spironolactone, especially if these medications can cause interactions.

  • Drink plenty of water while you take spironolactone. As a potassium-sparing diuretic, spironolactone can cause you to urinate more frequently than normal. Try to drink lots of water while you use spironolactone to avoid becoming dehydrated. 

When Should You Start Using Spironolactone for Hair Loss?

If you’re prone to female pattern hair loss, it’s generally best to begin treating it as soon as you first start to notice symptoms. 

In women, pattern hair loss usually starts as diffuse thinning that affects your part line -- the line on which your hair naturally parts from left to right. You may notice this line starting to become wider and less clearly defined, with thinning hair on either side.

If you’re concerned about hair loss, you can get help by talking to your primary care provider or scheduling an appointment with a dermatologist (a type of doctor that specializes in conditions that affect your skin, hair and nails). 

They may suggest using spironolactone or other hair loss medications to avoid further hair loss and stimulate regrowth.

Other medications for female hair loss include minoxidil, a topical solution that improves growth, and a combination of minoxidil and topical finasteride for treating postmenopausal hair loss

We offer these medications online in our range of women’s hair loss treatments, with finasteride available following a consultation with a licensed healthcare provider. 

How Does Spironolactone Work for Hair Loss?

As a hair loss medication, spironolactone works by reducing your body’s production of androgen hormones such as testosterone and DHT. It also stops these hormones from interacting with the androgen receptors in certain parts of your body, including your scalp.

Hair loss occurs when DHT attaches to receptors in your scalp, stopping your hair follicles from producing new hairs.

By reducing androgen levels and preventing DHT from damaging your hair follicles, medications like spironolactone can help to stop your hair loss from worsening, and in some cases, stimulate new hair growth.

Research shows that spironolactone is generally effective. For example, in one study, almost 75 percent of women who used spironolactone to treat pattern hair loss reported that their hair loss stabilized or that they started growing back lost hair.

Our guide to spironolactone for female hair loss goes into more detail about how spironolactone works to protect your hair follicles and prevent hair thinning.

Can Spironolactone Cause Side Effects?

Spironolactone is generally a safe, effective medication. However, it can potentially cause side effects and drug interactions. Most of these are mild and transient, although some may have a more noticeable impact on your daily life.

Common side effects of spironolactone include:

  • Dehydration

  • Hyponatremia (low blood sodium levels)

  • Nausea, vomiting, diarrhea and other gastrointestinal issues

  • Changes in appetite and eating disorders such as anorexia

  • Headaches, drowsiness, confusion and changes in motor control

  • Muscle pain, cramps and/or weakness

  • Skin rashes

Spironolactone can also cause issues that affect your breast tissue, such as breast pain, breast swelling and breast tenderness. Some women experience menstrual irregularities while taking spironolactone.

Other potential adverse effects of spironolactone include changes that affect your voice, hair growth in some areas of your body, post-menopausal vaginal bleeding, restlessness, tingling that affects your hands and/or feet and flu-like symptoms.

Although uncommon, spironolactone may also cause more serious side effects. Our guide to spironolactone side effects discusses these issues in more detail and provides information on what you can do if you experience side effects during treatment. 

Is it Safe to Use Spironolactone While Pregnant or Breastfeeding?

Spironolactone is a category C medication, meaning findings from animal studies show that it can cause fetal abnormalities. Because of its effects on androgen hormones, spironolactone may cause feminization in male fetuses.

If you’re pregnant or planning to become pregnant, you should not use spironolactone. If you are currently taking spironolactone to treat female pattern hair loss, acne or any other condition and become pregnant, talk to your healthcare provider as soon as you can.

Spironolactone generally appears safe to take while breastfeeding. However, it’s important to inform your healthcare provider if you’re currently breastfeeding before you start treatment with spironolactone. 

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Learn More About Treating Hair Loss

If you have female hair loss, spironolactone is one of several medications your dermatologist or primary care provider may suggest using to control shedding and promote regrowth. 

For most women, a single dose of spironolactone taken per day is enough to get hair loss under control. Your healthcare provider may suggest taking this in the morning, before going to bed or at any other time of day that’s convenient for you.

We offer spironolactone as part of our range of hair loss treatments for women, alongside other medications that can prevent shedding and promote thicker, healthier hair.

You can also learn more about treating and preventing hair loss in our detailed guide to the best hair loss treatments for women

7 Sources

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.

  1. Levy, L.L. & Emer, J.J. (2013). Female pattern alopecia: current perspectives. International Journal of Women’s Health. 5, 541-556. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/
  2. Spironolactone. (2018, February 15). Retrieved from https://medlineplus.gov/druginfo/meds/a682627.html
  3. Ho, C.H., Sood, T. & Zito, P.M. (2021, November 15). Androgenetic Alopecia. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430924/
  4. Brough, K.R. & Torgerson, R.R. (2017, March). Hormonal therapy in female pattern hair loss. International Journal of Women’s Dermatology. 3 (1), 53-57. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419033/
  5. Shannon, F., Christa, S., Lewei, D. & Carolyn, G. (2015, October). Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy. Journal of the American Academy of Dermatology. 73 (4), 705-706. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573453/
  6. Patibandla, S., Heaton, J. & Kyaw, H. (2021, July 18). Spironolactone. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554421/
  7. Drugs and Lactation Database (LactMed). (2022, January 18). Spironolactone. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK501101/

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.

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