Spironolactone

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What is Spironolactone?

Spironolactone is a potassium-sparing diuretic with antiandrogen properties, giving it a uniquely broad range of uses. It's prescribed for heart failure, high blood pressure, fluid retention from liver or kidney disease, and primary hyperaldosteronism. It's also widely used off-label for hormonal acne, female pattern hair loss, and hirsutism in women—conditions driven by androgen excess. By blocking both aldosterone receptors in the kidney and androgen receptors in target tissues, it addresses both fluid balance and hormone-driven conditions with a single medication. It's taken once or twice daily.

Aldosterone receptor blockade

Blocks mineralocorticoid receptors in the kidney's collecting tubules, preventing aldosterone from promoting sodium retention and potassium excretion—reducing fluid volume and blood pressure while conserving potassium.

Antiandrogen activity

Blocks androgen receptors in skin and hair follicles, reducing the hormonal stimulation that drives excess oil production, acne, unwanted hair growth, and female pattern hair loss—explaining its widespread off-label use in women.

Heart failure benefit

At appropriate doses, Spironolactone reduces mortality and hospitalizations in heart failure with reduced ejection fraction by blocking the harmful effects of excess aldosterone on the heart and blood vessels—a disease-modifying benefit beyond simple diuresis.

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