Main uses in hair loss: female pattern hair loss

Other names: Aldactone (trade name)

What is Spironolactone?

  • Spironolactone is an oral medication that blocks the effects of hormones called ‘androgens.’ 
  • This medication is used to treat hair loss.
  • One study suggested that it helps stop hair loss in approximately 40 % of women and helped improve hair density in another 40 % of women.

How is Spironolactone prescribed?

  • Your doctor will advise on spironolactone dosing. 
  • The maximal dose is 100 mg twice daily (200 mg). Your doctor may want you to use less, especially when starting.

Can I use Spironolactone with other treatments? 

  • You should NOT use Spironolactone if you are on these medications: ACE-inhibitors, angiotensin receptor inhibitors, potassium pills, digoxin, lithium, NSAIDS and thiazide diuretics

Who should not use Spironolactone?

Spironolactone is not for everyone, especially men. Many women should also not use spironolactone. Check with your doctor if this medication is right for you. 

A woman should not use Spironolactone if  she has (or is):

  • undiagnosed hair loss
  • kidney problems
  • high potassium levels in the blood
  • is pregnant or wish to become pregnant in the very near future (women must not get pregnant on this medication)
  • is breast feeding
  • has abnormal uterine bleeding
  • has family history or personal history of breast, ovarian or uterine cancer
  • has a history of gastrointestinal bleeding (GI bleeding) or gastric ulcers


What side effects are possible with Spironolactone?

Several side effects are possible with Spironolactone. Be sure to review all side effects with your physician. A partial list is shown below:

  • Menstrual irregularities (being on  the birth control pill may helpf make periods regular)
  • Breast tenderness and enlargement
  • Rarely you can feel dizzy when you stand up quickly
  • High potassium in the blood (rare in healthy women)
  • Fatigue
  • Decreased libido (sex drive)
  • GI upset: Nausea, vomiting, diarrhea, ulcers and bleeding are very rare
  • Teratogenicity – This means that it may cause abnormalities in a developing fetus (baby) if a woman gets pregnant while on this medication. Women can have healthy babies once they stop this medication but must never get pregnant while on this medication.

What side effects should prompt me to STOP Spironolactone and get medical advice?

  • Stop taking Spironolactone and get medical help if you develop a rash, hives, shortness of breath, swelling in the lips or feel unwell
  • Stop if you have any concerns at all
  • Stop if you develop breast enlargement, bumps or lumps in the breast or discharge.
  • What tests should I have when I am on this medication?
  • Your blood pressure will be monitored while you are on this medication.
  • You may be advised to get blood work while on this medication.

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