Spironolactone: Uses, Side Effects, and What It Treats

When you hear spironolactone, a potassium-sparing diuretic used to treat fluid retention and high blood pressure. Also known as Aldactone, it works by blocking the hormone aldosterone, which tells your body to hold onto salt and water. Unlike other water pills that make you lose potassium, spironolactone helps you keep it—making it useful for people who need to avoid low potassium levels.

It’s not just for high blood pressure. Doctors often prescribe it for heart failure, a condition where the heart can’t pump blood effectively because it reduces swelling and eases breathing. It’s also used for edema, fluid buildup in the legs, belly, or lungs caused by liver disease or kidney problems. And yes—it’s sometimes used off-label for hormonal acne or female-pattern hair loss, since it lowers androgen activity.

But it’s not without trade-offs. Because it keeps potassium in, too much can be dangerous—especially if you have kidney issues or take other meds that raise potassium. Some people get breast tenderness, menstrual changes, or fatigue. Men might notice reduced libido or gynecomastia. It’s not a quick fix, and it doesn’t work the same for everyone. That’s why it’s often paired with other blood pressure drugs like hydrochlorothiazide or losartan to get better results without higher doses.

You’ll find posts here that compare spironolactone to other diuretics, explain how it affects sleep or kidney function, and break down real-world experiences with long-term use. Some talk about how it interacts with alcohol or other heart meds. Others cover what to do if you miss a dose, or how to manage side effects without quitting the drug. This isn’t just a list of facts—it’s a collection of practical insights from people who’ve lived with it, doctors who’ve prescribed it, and researchers who’ve studied its long-term impact.