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Understanding How Spironolactone Works and Unapproved Uses

How Does Spironolactone Work?

Spironolactone is a diuretic, which is commonly referred to as a "water pill." It is known as an "aldosterone antagonist," which means it blocks aldosterone receptors. Aldosterone is a hormone in the body that causes the body to retain water. By blocking aldosterone, spironolactone increases the amount of salt and water that the kidneys remove from the blood. This extra salt and water is passed out through urine. By increasing the amount of water removed from the blood, spironolactone causes a decrease in blood volume. Because of this effect, spironolactone can lower blood pressure and also help with water retention.
Spironolactone is a "potassium-sparing" diuretic, which means that it does not cause low potassium levels in the blood (like many other diuretics). In fact, spironolactone usually increases potassium levels, an effect which can be used to treat low potassium levels (hypokalemia).

Spironolactone Use in Children

Spironolactone has not been adequately studied in children or adolescents and is not approved for these age groups. Talk to your child's healthcare provider about the benefits and risks of using spironolactone in children.

Off-Label Spironolactone Uses

On occasion, your healthcare provider may recommend spironolactone for treating a condition other than those listed above. This is called an "off-label" use. At this time, spironolactone is used off-label to treat the following conditions:
  • Acne in women (see Spironolactone for Acne Treatment)
  • Bloating and water retention due to premenstrual syndrome (PMS)
  • Bronchopulmonary dysplasia (a lung disease in babies)
  • Hirsutism (excess body hair in women)
  • Hair loss in women
  • Polycystic ovarian syndrome (PCOS).
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