Any Benefit (Or Harm) in Taking Accutane and Spironolactone at the Same Time?

Question

I was on spironolactone (started at 50 mg/day and ramped up to 200 mg/day) for about 5 months but was still experiencing a lot of issues with breakouts, including large cysts between my eyes, so my dermatologist prescribed Absorica. He said if I wanted to stay on the spironolactone while on Absorica I could, but I can't really find any literature about medication interactions, etc. Is this common practice, or is it better to stop the spiro while I'm doing my course of isotretinoin? Thanks!

Melissa Chiang, MD, FAAD · Answer

I usually use accutane (along with birth control in female patients) as an "exclusive" medication because:1) accutane is such a powerful and effective medication, it usually does not need any "partners" to help clear up acne2) accutane has a lot of side effects, including, most commonly, dryness of the skin.  Most other topical acne medications, including otc acne medications, will exacerbate this dryness.  Spironolactone could contribute to more dryness because it decreases sebum production.

Arnold R. Oppenheim, MD (retired) · Answer

My suggestion would be to drop the dose of Spironolactone as your acne resolves. There should be no interaction and problems with taking both drugs simultaneously. In fact, since you are on birth control pills and are having monthly blood tests, this might be an ideal time to get rid of your acne quickly and effectively.

	Be sure that your physician adds a potassium level to the monthly pregnancy blood test as Spironolactone is potassium sparing. This might cause an elevation in potassium.  Also, since you are being seen anyway, a blood pressure should be taken with each visit.

Any Benefit (Or Harm) in Taking Accutane and Spironolactone at the Same Time?

Answers (2)