Avoid These Medications and Foods With Spironolactone — Plus, 4 More Tips for Taking It

Spironolactone (Aldactone, CaroSpir) is a type of aldosterone antagonist. The prescription-only medication has a wide range of uses, and a large number of people take it to help manage their health in some capacity.

While many people find success with spironolactone, taking it can come with some risks. In addition to potential side effects, spironolactone can interact with certain foods and medications. But there are several ways to mitigate these risks.

Keep reading to learn five top-tier tips for getting the most out of your spironolactone prescription.

1. Spironolactone is prescribed for many conditions

Spironolactone has many possible uses. Some people even take it to treat more than one health condition. 

Spironolactone is FDA approved to treat:

• Heart failure

• Hypertension (high blood pressure)

• Edema (swelling caused by fluid buildup)

• Hyperaldosteronism (too much aldosterone in the body)

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Spironolactone can treat many health conditions because of how it works. Spironolactone blocks the hormone aldosterone from working. When it does this in the kidneys, it acts like a diuretic (water pill). This causes extra fluid to leave the body, which can improve a variety of symptoms.

Spironolactone also has a number of off-label uses. This means that it may be beneficial for certain health conditions that it hasn’t officially been approved to treat. Notable examples include:

• Acne

• Female-pattern baldness

• Hirsutism (excess body hair in women)

• Hidradenitis suppurativa (a type of long-term skin inflammation)

• Heart attack aftercare

2. Spironolactone comes in several doses and dosage forms

Sprironolactone comes as an oral tablet and as a liquid suspension, which is banana-flavored. Although you may be prescribed either one, they’re not considered equivalent. So you shouldn’t switch from the tablet to the suspension (or vice versa) without talking to your prescriber first.

There are multiple doses to choose from, as well. Spironolactone comes in 25 mg, 50 mg, and 100 mg tablets. (For people who take large dosages, this can lower the number of tablets that are taken at once.) The liquid suspension comes in a concentration of 25 mg/5 mL.

One formulation isn’t considered better than the other, since they both deliver similar results. Which one you take will likely boil down to your preferences and, possibly, your health insurance status.

3. It doesn’t matter if you take your doses with food

Most people take spironolactone once or twice a day. Though, it doesn’t matter if it’s taken with or without food, which makes it slightly more convenient than some other medications.

What’s more important than whether or not you take it with food is consistency. You should aim to take your doses the same way, at consistent times, every day.

This is helpful for two reasons. The first is that it ensures the same amount of medication makes its way into your body each time. The second is that, when you’re consistent, it becomes less likely that you’ll forget to take a dose.

4. Spironolactone has a number of potential risks and side effects, including high potassium levels

Spironolactone impacts the levels of certain hormones in your body. This means it has the potential to cause some side effects.

One of the most notable is that it can raise potassium levels in the blood. In some cases, this is actually useful. For example, if you have a history of low potassium, taking spironolactone may improve your situation. But, for other people, spironolactone increases the risk of hyperkalemia (high potassium), which can cause symptoms like nausea, muscle weakness, and an irregular heartbeat.

Spironolactone can also cause side effects that aren’t directly related to hyperkalemia. These include:

• Gynecomastia (male breast development)

• Muscle cramps

• Dehydration

• Hyponatremia (low sodium levels)

• Irregular menstruation

While very rare, spironolactone also has the potential to cause a serious skin rash called Stevens-Johnson syndrome (SJS). The rash associated with SJS causes your skin to become inflamed, form blisters, and peel off. If you notice any unusual skin changes, it's important to call 911 or go to the nearest ER. SJS is considered a medical emergency.

5. There are certain foods (and medications) to avoid while taking spironolactone

A number of foods and medications can impact how spironolactone works. It’s best to avoid (or minimize) these substances when possible.

Foods to avoid with spironolactone

Do your best to avoid foods that are high in sodium or potassium while taking spironolactone.

Salty foods have a lot of sodium, which causes the body to hold onto extra water. Large amounts of sodium may make it harder for spironolactone to do its job, since the medication works by getting rid of extra water.

While potassium-rich foods support heart health, they could worsen the risk of hyperkalemia related to spironolactone. So it’s good to be cautious about how much you consume. Your prescriber can tell you how much potassium you should try to incorporate in your diet.

Common examples of potassium-rich foods include:

• Carrot juice

• Clams

• Kiwi

• Leafy greens

• Orange juice

• Potatoes (with skin)

• Prune juice

• Yogurt

Medications to avoid with spironolactone

Spironolactone has some drug interactions to consider, too.

As discussed, spironolactone has the potential to raise potassium levels. So taking it alongside other medications that raise potassium levels may make for a risky combination. This includes angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and potassium supplements.

Other medications that have been known to interact with spironolactone include nonsteroidal anti-inflammatory drugs (NSAIDs), digoxin (Lanoxin), and lithium (Lithobid).

Whenever you start taking a new medication, it’s good practice to give both your pharmacist and prescriber a complete list of the medications and supplements that you take. They’ll screen the list for potential interactions to help protect your health and maximize the benefits of your medications.

How to save on spironolactone

There are many ways to save on spironolactone, which is available as both a brand-name and a generic medication:

• Save with GoodRx. GoodRx may be able to help you save over 60% off the average retail price of the generic version of spironolactone. Generic spironolactone’s price at certain pharmacies may be as low as $5.40 with a free GoodRx coupon.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 a month for name-brand CaroSpir using a savings card from the manufacturer.

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Written by:

Nathan Williams, PharmD, RYT

Nathan is a clinical pharmacist, certified yoga instructor, and medical content writer. His clinical practice has spanned several sub-specialties including: emergency medicine, nutrition, and pediatrics.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Amy B. Gragnolati, PharmD, BCPS

Amy Gragnolati, PharmD, BCPS, is a pharmacy editor for GoodRx. Amy currently holds her pharmacist license in Georgia and California.

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