Rankings / Hormones & Endocrine
Spironolactone
Hormones & Endocrine · Aldosterone / androgen receptor antagonist
Tier B
Bottom line
Read Off Label grades Spironolactone as B (6.8/10) based on strong evidence, strong benefit magnitude, and a med-risk safety profile.
Workhorse for women's androgen-driven conditions.
Typical use: 50-200 mg/day PO (dermatology); 25-100 mg/day (cardiac/HTN) — Rx.
What this is
Workhorse for women's androgen-driven conditions. FDA 2022 removed the long-standing but evidence-free breast cancer black box. Not for men (feminizing). Typical contraception recommended during use for women of childbearing potential due to fetal feminization concerns.
Mechanism
Potassium-sparing diuretic with antiandrogen activity (AR antagonism); reduces androgenic effects on skin and hair follicles; first-line for female-pattern AGA, female hormonal acne, hirsutism
Dose & route
50-200 mg/day PO (dermatology); 25-100 mg/day (cardiac/HTN)
Citations
- https://pubmed.ncbi.nlm.nih.gov/35028910/
- https://pubmed.ncbi.nlm.nih.gov/28178380/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8390950/
Links go to the source. If a link is dead or you want something re-checked, let me know.
Common questions
- Does Spironolactone work?
- Read Off Label rates the evidence for Spironolactone as Strong and the benefit magnitude as strong, producing an overall grade of B (6.8/10). Workhorse for women's androgen-driven conditions.
- Is Spironolactone safe?
- Spironolactone has a med risk profile in published human data. Legal status: Rx. This is not medical advice — see the disclaimer.
- What is the typical dose for Spironolactone?
- 50-200 mg/day PO (dermatology); 25-100 mg/day (cardiac/HTN)
- How does Spironolactone work?
- Potassium-sparing diuretic with antiandrogen activity (AR antagonism); reduces androgenic effects on skin and hair follicles; first-line for female-pattern AGA, female hormonal acne, hirsutism
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.