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Compare Propecia vs. Spironolactone

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Propecia (finasteride) and Aldactone (spironolactone) are both prescription medications, but they serve different purposes and belong to different drug classes. Propecia is a 5-alpha reductase inhibitor used to treat male pattern baldness by blocking the enzyme that converts testosterone to dihydrotestosterone (DHT), which can cause hair loss when levels are high. It is taken once daily and can cause sexual side effects like low sex drive and erectile dysfunction. On the other hand, Aldactone is a potassium-sparing diuretic used to treat conditions like heart failure, high blood pressure, and swelling due to kidney or liver problems. It works by blocking aldosterone, a hormone that affects sodium and potassium levels, and can cause side effects such as breast tenderness and lower sex drive in males. While both medications are available in generic forms, spironolactone also comes in an oral suspension for those who have difficulty swallowing tablets. Additionally, spironolactone requires regular blood tests to monitor electrolytes and kidney health, whereas finasteride does not.

  • Finasteride (Propecia)
    Spironolactone (Aldactone)
  • Finasteride (Propecia)
    Spironolactone (Aldactone)

  • Summary of Propecia vs. Spironolactone

    Summary for 5-alpha reductase inhibitor
    Prescription only

    Finasteride 1 mg (also known by its brand name Propecia) is used to prevent and treat hair loss. It isn't the same as finasteride 5 mg (brand name Proscar), which is used for enlarged prostate. Finasteride (Propecia) is taken by mouth once per day and is available by prescription only. Side effects aren't common, but typically include sexual problems (e.g., low sex drive, erectile dysfunction, lower ejaculation volume).

    Summary for Potassium sparing diuretic
    Prescription only

    Spironolactone (Aldactone) is a type of potassium-sparing diuretic (water pill). It's used to treat heart failure, high blood pressure, and swelling from kidney or liver problems in adults. Because it blocks aldosterone (a hormone that affects sodium and potassium levels), spironolactone (Aldactone) can also treat conditions where there's too much aldosterone. Spironolactone (Aldactone) is taken by mouth, generally once or a few times a day, depending on your condition. Some common side effects of this medication include breast tenderness (males and females) and loss of libido (in males).

  • Indications of Propecia vs. Spironolactone

    Indications for
    •Male pattern baldness due to hormones (androgenetic alopecia) in adults
    Indications for
    •Heart failure
    •High blood pressure
    •Swelling due to liver damage (cirrhosis)
    •Swelling due to nephrotic syndrome (a rare kidney condition) - tablets only
    •Primary aldosteronism (a hormone imbalance) - tablets only

  • Pros and Cons of Propecia vs. Spironolactone

    Pros and Const for 5-alpha reductase inhibitor
    Pros
    •Works well to grow hair in males who are balding
    •Taken by mouth once per day
    •Doesn't have a lot of side effects
    Cons
    •Not a cure; hair loss will come back after stopping finasteride (Propecia)
    •Takes 3 months or longer to see the full benefits
    •Can cause sexual problems (e.g., lower sex drive, difficulty keeping an erection, low ejaculation volume)
    Pros and Const for Potassium sparing diuretic
    Pros
    •Taken by mouth
    •Oral suspension available for adults who've difficulty swallowing tablets
    •Lower-cost generics available
    Cons
    •Can make you urinate more often
    •Need to get blood tests regularly to check your electrolytes and kidney health
    •Can cause breast growth and lower sex drive in males

  • Common Side Effects of Propecia vs. Spironolactone

    Common Side Effects for
    •Lower sex drive (2%)
    •Erectile dysfunction (1%)
    •Ejaculation problems (1%)
    Common Side Effects for
    •Dizziness
    •Headache
    •Sleepiness
    •Nausea
    •Vomiting
    •Diarrhea
    •Stomach cramps
    •Enlargement of male breasts
    •Breast pain
    •Lower sex drive
    •Sexual dysfunction
    •Irregular or lack of menstrual periods
    •Leg cramps
    •Higher potassium levels
    •Lower sodium levels

  • Warnings of Propecia vs. Spironolactone

    Common Side Effects for
    •Risk of harm to babies
    •Changes to prostate-specific antigen (PSA) levels
    Common Side Effects for
    •High blood potassium levels
    •Low blood pressure and kidney problems
    •Abnormal electrolyte levels
    •Breast pain or swelling

  • Prices with our coupons for Propecia vs. Spironolactone

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    Learn more about Spironolactone

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