Spironolactone Dosage for Treatment of Acne

The label on your acne medication says: "Spironolactone. Take 100 mg every day." Is this too little? Too much?



Spironolactone comes in 25 mg and 50 mg tablets, and you can take it all at once or split the dose, as your doctor recommends. It treats acne by decreasing the skin's production of sebum (oil), which is what the acne-causing bacteria feed on. Treating acne is an "off-label" use for spironolactone; it was originally prescribed to treat hypertension (high blood pressure).

Recommended Dose

• The dose for acne varies from 25 to 200 mg a day. The usual starting dose is 100 mg a day, but your doctor may prefer to start low and increase it as he sees how you react to the medication. A high dose would be 300 mg per day.

Progress

• Some patients see an immediate improvement, but it can take up to six months to see dramatic results. Your skin should become less red and oily, and you may see less facial hair. You may also feel a little tired.

  Because spironolactone has a diuretic effect, you may urinate more often.

Targeted Patients

• According to the December 2009 issue of the Journal of Clinical and Aesthetic Dermatology, spironolactone is generally well-tolerated by women, but its use by men has been limited, because of such side effects as lowered sex drive, erectile dysfunction and breast enlargement. If you're pregnant or get pregnant while taking spironolactone, tell your doctor--it could affect the sexual development of a male fetus.

Serious Side Effects

• If you take potassium supplements with spironolactone, in an extreme case you could develop a life-threatening condition called "hyperkalemia" (too much potassium in your blood). If you suddenly get weak, have trouble breathing or experience tingling in your hands and feet, or your heart beats very slowly or irregularly, call 911 or go to the nearest emergency room. Take all your medicines with you.