Spironolactone
Skin/Hair · Aldosterone / androgen receptor antagonist
Tier B+
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/
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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.