Spironolactone side effects: do you suggest that I tough it out, adjust the dose, or discontinue taking it?

Question

On spironolactone 50mg once/day for 7 weeks. I had acne on my back, shoulders, and underneath my chin, and saw immediate improvement. My skin currently looks fabulous. Unfortunately, my period was a week late, and now I've been menstruating for 14 days without stopping. Also abnormally bad cramping to the point that I need to lie down. I have a thin/athletic body type, but I have noticed much accumulated fat on my legs and hips, my clothing doesn't fit anymore, and I feel swollen similar to PMS.

Amy Y. Paul, DO, FAAD · Answer

Thanks for your question.  You might want to ask your dermatologist or prescriber if decreasing the dose is an option.   Some of my patients do fine on just 25mg daily without side effects, but found the 50mg too much.  If you decide the sprionolactone is absolutely not tolerable, please consider a course of low-dose accutane with your dermatologist, as long as you aren't planning pregnancy any time soon.  I have a lot of adult women who do wonderfully on a 4-6 month course of lower dose accutane to "finish off" their acne once and for all.  The side effects of accutane are not hormonal at all and are basically severe dryness, which you combat with good quality moisturizers and sunscreen.  Best of luck!

Laura A. Katz, MD · Answer

Spironolactone is potentially a wonderful medication for hormonal acne, but it has a number of potential side effects.  Some common side effects include enlarged breasts, high potassium levels, nausea and vomitting, abdominal cramps, diarrhea, headache and menstrual irregularities to name a few.  It sounds like you are experiencing several of these.  At Laura A. Katz MD PC we would suggest stopping the medication.

Spironolactone side effects: do you suggest that I tough it out, adjust the dose, or discontinue taking it?

Answers (2)