OverviewDosageSide EffectsInteractionsHalf-Life

Spironolactone may not be the right choice for every patient. In such cases, it is important to discuss with a medical provider potential spironolactone alternatives.

Spironolactone Alternatives — What Are Your Options?

What are your options when it comes to alternatives for spironolactone?

For Acne

When spironolactone isn’t an option for acne, other oral medications are available. These include:

  • isotretinoin (Zenatane, Accutane) – See these Accutane before and after results.
  • combination oral contraceptives (birth control pills that contain both estrogen and progesterone), and 
  • antibiotics, such as a tetracycline or a macrolide.

It’s important to note, though, that these alternatives are not without their drawbacks. For instance, antibiotics are only meant for short-term use, and other medications can cause different side effects, such as nausea.

For Hair Loss

For those who are unable to use spironolactone for hair loss, other medication options include oral dutasteride, finasteride (Propecia), and minoxidil (Rogaine). Finasteride is a prescription medication for men, while minoxidil is a nonprescription medication for men and women. Keep in mind that you should always talk to your medical provider before taking any medication for hair loss.


Alternative options for treating PCOS (polycystic ovary syndrome) symptoms, such as excessive hair growth, include birth control pills that reduce androgen production and eflornithine (Vaniqa) for slowing the growth of facial hair in women.

For Blood Pressure

Several medications to help treat blood pressure are available for those who cannot take spironolactone. Some of these include alpha blockers, alpha-beta blockers, renin inhibitors, vasodilators (blood vessel-widening drugs), central acting agents, and beta blockers.

For Hirsutism

Those who are unable to take spironolactone for hirsutism (excessive hair growth in areas such as the face and back) have other options available. These include oral contraceptives and topical creams, such as eflornithine for facial hair. Other anti-androgens, such as finasteride and flutamide (Eulexin), are also alternatives for hirsutism.

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.


Generic Name: Spironolactone


Class: Aldosterone antagonist, potassium-sparing diuretic

Availability: Prescription

Molecular Formula: C24H32O4S

Substance UNII: 27O7W4T232

What is Spironolactone?

Spironolactone is an aldosterone antagonist and potassium-sparing diuretic. It is often sold under the trade names Aldactone and CaroSpir.

What is Spironolactone Used For?

The FDA has approved spironolactone for the treatment of heart failure, hypertension, edema associated with nephrotic syndrome or hepatic cirrhosis, and primary hyperaldosteronism. People also sometimes use it to treat acne or to promote weight loss.

How Does Spironolactone Work?

Spironolactone works by blocking the activity of aldosterone, a steroid hormone associated with water retention. This fluid retention can cause certain problems to worsen such as kidney, heart, or liver diseases or conditions. Taking this medication causes higher amounts of water and sodium to be eliminated, thereby reducing water retention.

Spironolactone also prevents your body from excreting or getting rid of potassium. Notably, potassium helps reduce water retention through promoting urination and excretion of sodium during urination.

How Long Does It Take for Spironolactone to Work?

The time it takes for this drug to work depends on what it is being used for and other factors, such as the presence of other medical conditions and dosage being taken. A 2012 study found that it generally takes a few weeks for spironolactone to become effective when it is used for treating acne.

Do Not Use Spironolactone If:

There are several situations where this medication may not be the right choice for you. According to the FDA, the following should not use spironolactone:

  • Patients with hyperkalemia (high potassium)
  • Patients with Addison’s disease (hypocortisolism or adrenal insufficiency)
  • Patients who are using eplerenone (Inspra)

Please note that this list may not be complete, and there may be other situations where use of this drug is not advisable.

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.

More about Spironolactone

Written by

Medically reviewed by