What is the most important information that I should know about Spironolactone for the treatment of female pattern hair loss (androgenic alopecia):
Spironolactone is FDA-approved for the treatment of:
- Heart failure
- Primary hyperaldosteronism
Although spironolactone is not FDA-approved for the treatment of female pattern hair loss, it is often used in dermatologic healthcare for this reason.
- Spironolactone is not used for the treatment of hair loss in men due to side effects (e.g., enlargement of breast tissue) related to its anti-androgenic properties.
- Through the Hers platform, spironolactone is only available to premenopausal women, born female, between the ages of 18-43.
- If you have the potential to become pregnant, you must be on a reliable form of birth control while taking spironolactone due to the risk of birth defects associated with spironolactone. Please see below for more information about this.
Are there any dietary restrictions that I should follow while taking spironolactone?
While taking spironolactone, excessive potassium intake should be avoided. This includes avoiding potassium-containing supplements in addition to salt substitutes that contain potassium. Coconut water contains high amounts of potassium and should be avoided. Most other foods, including bananas, are safe to consume in moderation.
Drinking alcohol may increase certain spironolactone side effects, such as headache or dizziness.
Do not use spironolactone for the treatment of your female pattern hair loss if you:
- Are allergic or hypersensitive to spironolactone or any component of spironolactone’s formulation
lactose monohydrate, dibasic calcium phosphate, povidone, peppermint oil, purified talc, pregelatinized starch, colloidal anhydrous silica, magnesium stearate, hypromellose, polyethylene glycol 400, titanium dioxide, iron oxide yellow, iron oxide red
- Are currently taking eplerenone
- Have hyperkalemia
- Have Addison’s disease
- Are pregnant or breastfeeding or are planning to become pregnant
If any of the following apply to you, please speak with a healthcare provider in-person about seeking treatment for your female pattern hair loss:
- Younger than 18 years of age
- You are taking any of the following medications:
- Daily use of acetylsalicylic acid (aspirin) or NSAIDS (e.g., ibuprofen, advil, aleve, naproxen).
- Potassium supplements
- Drugs that increase serum potassium levels (e.g., ACE-inhibitors, angiotensin-receptor blockers, Heparin or low molecular weight heparin)
- You have any of the following conditions:
- Kidney or liver disease
- Electrolyte imbalances
- Heart disease
- Adrenal gland disorder
- Irregular menstrual periods that have not been evaluated by a healthcare provider in-person
- Recent onset of excessive hair growth on the face or body, enlargement of the clitoris, and/or deepening of the voice
These are some of the more common side effects of spironolactone:
- Headache, dizziness, drowsiness, confusion
- Nausea, vomiting, diarrhea
- Abdominal pain
- Irregular menstrual periods
- Breast tenderness/enlargement
- Decreased libido
Contact your healthcare provider right away if you experience any of these side effects:
Hyperkalemia (elevated potassium level in your blood) is a reported serious side effect of spironolactone. Hyperkalemia is rarely seen in young, healthy individuals under 45 without underlying kidney or heart disease. Contact your healthcare provider right away if you experience any of the following symptoms of hyperkalemia:
- Muscle pain or weakness
- Difficulty with breathing
- Irregular heartbeat
- Tingling or numbness in the arms, hands, legs, or feet
These are not all of the possible side effects of spironolactone. For more information, ask your healthcare provider or pharmacist.
Contract your healthcare provider for medical advice about side effects. You can message a healthcare provider through your Hers account if you have any questions about your treatment, including any side effects you may be experiencing. You may report side effects to FDA by calling 1-800-FDA-1088 or visiting http://www.fda.gov/MedWatch
If I am sexually active, is it important to use an effective form of contraception while taking spironolactone?
Yes, spironolactone can potentially cause birth defects in a developing fetus (e.g., feminization of a male fetus). If you are concerned that your birth control method was ineffective or failed, over-the-counter emergency contraception is available but must be taken within 72 hours (3 days) following the sexual act. Prescription emergency contraception (ella®) is also available through a healthcare provider and must be taken within 5 days following the sexual act.
Oral contraceptive pills are often prescribed with spironolactone as a form of birth control and to help maintain regular menstrual periods while preventing side effects, such as breast tenderness.
If you become pregnant while taking spironolactone, you should immediately stop taking spironolactone and inform a medical professional.