Spironolactone Tablet
An oral prescription medication with anti-androgen effects that is commonly used off-label for female-pattern hair loss.
Active ingredients: Spironolactone
$59 per month
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Spironolactone is FDA-approved for several cardiovascular/endocrine indications, not for hair loss. Hair-loss use is off-label.
What it does
Spironolactone is a potassium-sparing diuretic that also blocks some androgen effects. It is not a hormone. For hair loss, clinicians use it off-label.
What's in it
Spironolactone
- What it is
- Prescription potassium-sparing diuretic with anti-androgen effects.
- Hormone?
- Not a hormone.
- Why it's here
- It blocks some effects of androgen hormones and can raise potassium.
Why choose this one?
Why choose this one
Most relevant when androgen activity is believed to contribute to hair thinning.
Why choose Minoxidil Tablet instead?
Minoxidil focuses on hair growth rather than androgen signaling. Some people use the two approaches together under clinician guidance.
Compare your options
Minoxidil vs DHT blockers
| Minoxidil | DHT blockers (finasteride, dutasteride) | |
|---|---|---|
| How it works | Supports the growth phase of the hair cycle | Lowers DHT, the hormone that shrinks follicles in pattern hair loss |
| Who it's for | Men & women | Mainly men |
| Hormone? | No | No, but acts on a hormone pathway |
| What to know | Must be continued; early shedding; oral forms can cause unwanted body hair | Sexual side effects in a small minority; pregnancy restrictions |
| Used together? | Often, because they work through different pathways | Often, because they work through different pathways |
Benefits and evidence
Spironolactone for female pattern hair loss
- What the study found
- About 57%
- Who was studied
- Patients with female pattern hair loss, across multiple studies
- What it means
- A systematic review found improvement in roughly 57% of patients studied, although treatment approaches and outcomes varied considerably across studies.
- Important context
- The underlying studies were heterogeneous and the review states more research is needed. This is not a guaranteed response rate. Oral spironolactone · Varied across studies
- Source
- The Efficacy and Safety of Oral Spironolactone in the Treatment of Female Pattern Hair Loss: A Systematic Review and Meta-Analysis Cureus, 2023, PMID 37719557
Common side effects
More frequent urination, dizziness, breast tenderness, menstrual changes, headache and lower blood pressure. Spironolactone can also raise potassium.
What may help
General measures that may help:
- Stand up slowly if you feel lightheaded, and stay hydrated.
- Avoid potassium supplements and potassium-based salt substitutes unless your clinician approves them.
- Tell your clinician about blood-pressure, heart or kidney medicines you take.
- Menstrual changes or breast tenderness are common. Mention them at follow-up.
Your clinician may recommend blood tests depending on your health history.
Important safety information
Pregnancy and fertility. Not used during pregnancy. Based on how it works and animal studies, spironolactone may affect the development of a male fetus, so clinicians usually discuss reliable contraception.
Spironolactone can cause high potassium and worsening kidney function. Potassium supplements, certain blood-pressure drugs and kidney disease can increase risk. Pregnancy considerations are important because of potential effects on male fetal sex differentiation.
Prescription treatments require evaluation by a licensed clinician and are not appropriate for everyone. Some ingredients are not appropriate during pregnancy or for people who may become pregnant. Compounded formulas are not FDA-approved. Not available in all states.
When to contact your clinician
Contact your clinician promptly about muscle weakness, an irregular heartbeat, severe dizziness or passing much less urine (these can be signs of high potassium or dehydration). Tell your clinician right away if you could be pregnant.
Questions people ask
Is this a hormone?
Not a hormone. It is a prescription medication with anti-androgen activity.
Is this the same as minoxidil?
No. Minoxidil supports growth. Spironolactone addresses androgen signaling. They may be used separately or together.
How well does spironolactone work for hair thinning in women?
A 2023 systematic review found improvement in roughly 57% of patients studied, but the studies used different doses and measured results differently, and the review called for more research. It is not a guaranteed response rate.
How long before I see results?
Hair grows slowly, so changes usually take months. In the finasteride trials and the 48-week topical minoxidil trial, results were measured over the better part of a year or longer. Your clinician can tell you when a review makes sense.
Which hair-loss medications matter if pregnancy is possible?
Spironolactone, finasteride and dutasteride can affect a male fetus and are avoided if pregnancy is possible. Oral minoxidil and topical tretinoin are also usually avoided during pregnancy. Tell your clinician about any pregnancy plans.
Discuss Spironolactone Tablet with a licensed clinician
Your clinician reviews your health history and decides whether this option, or another, is appropriate.
$59 per month
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Spironolactone Tablet $59 per month