Do I need to change my diet if I am taking 2 (and working up to 3) 25mg dose/day of spironolactone for acne?

Question

I am starting spironolactone for acne along with antibiotics. I read there is a risk for hyperkalemia and was wondering if I need to change my diet and only eat low potassium foods? I eat a lot of vegetables currently and those tend to have high K. I also already have low blood pressure, what can I do to prevent from getting even more dizzy on the medication? Thank you

Melissa Chiang, MD, FAAD · Answer

Great question.If you are young and healthy, you can eat what you like.If you have kidney dysfunction or are on other medications that make your body retain potassium, then you should consult your doctor about whether you need to reduce potassium intake.To prevent dizziness, drink more water!  Also, you can try splitting up your spironolactone dosage into two doses.

Narin (Joe) Apisarnthanarax, MD · Answer

It is true that spironolactone can cause potassium retention.  If you have normal kidney function and are not on other medications that make you retain potassium (some blood pressure medications), then normal intake of potassium in foods is just fine.  I would not go on a binge diet of bananas and coconut water, however.  You may experience increased urinary frequency, so be sure to stay well hydrated, which should lower your risk of dizziness.  You are also on the lowest dose of the medication, so you should be at low risk of listed side effects.

Do I need to change my diet if I am taking 2 (and working up to 3) 25mg dose/day of spironolactone for acne?

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