> ## Documentation Index
> Fetch the complete documentation index at: https://docs.hi-doctor.ai/llms.txt
> Use this file to discover all available pages before exploring further.

# Spironolactone

> Spironolactone treats blood pressure and heart failure. Its off-label use for female pattern hair loss carries no EU authorisation.

Spironolactone is a water tablet authorised in EU countries, including
Spain, to treat high blood pressure, some types of heart failure, and
conditions where the body makes too much of the hormone aldosterone. It
also has a weak anti-male-hormone effect, which is why some doctors
prescribe it off-label for female pattern hair loss — but that use has no
EU authorisation anywhere, and it is not something Hi-Doctor prescribes.

<Warning>
  Spironolactone has no EU marketing authorisation for female pattern hair
  loss. It is an approved medicine for something else (blood pressure, heart
  failure, excess aldosterone) — but not something a doctor here can
  prescribe for hair loss.
</Warning>

## What it is

A tablet authorised in the EU for high blood pressure, some types of heart
failure, and conditions of excess aldosterone. Its use for hair loss is
off-label everywhere in Europe.

## How it works

Spironolactone blocks the hormone aldosterone in the kidney, so the body
passes more salt and water in urine. It also partly blocks the effect of
male hormones on body tissue — the mechanism behind its off-label use for
hair loss.

## What the studies reported

<Note>
  Results are grouped by source and evidence grade so journal data and
  manufacturer announcements cannot be confused.
</Note>

The evidence for hair loss comes from five pooled studies (413 patients
total), mostly observational, using doses from 25 to 200 mg and durations
from six months to over a year. None compared spironolactone against a
placebo, so these figures cannot be separated from natural variation or
from other treatments taken at the same time.

## What has been reported

| Effect                   | Reported rate (pooled, 413 patients) |
| ------------------------ | ------------------------------------ |
| Scalp itching or flaking | 18.9%                                |
| Menstrual changes        | 11.9%                                |
| Facial hair growth       | 6.9%                                 |

The Spanish product information additionally lists irregular menstruation,
absent periods and post-menopausal bleeding as adverse reactions.

## Can I get it here?

Not for this use. Spironolactone has no EU authorisation for hair loss, so
it cannot be prescribed or dispensed here for that purpose. What can you
take instead? Minoxidil is approved in the EU, has published peer-reviewed
trial results, and can be prescribed today if a doctor decides it suits
you.

## Available hair-growth alternatives

<CardGroup cols={2}>
  <Card title="Oral finasteride" icon="pills">
    A 5-alpha-reductase inhibitor taken daily. A doctor may prescribe it
    after reviewing your history and ruling out contraindications.
  </Card>

  <Card title="Oral minoxidil" icon="pills">
    Low-dose, used off-label by some dermatologists. Requires close
    medical supervision for potential cardiovascular effects.
  </Card>

  <Card title="Topical minoxidil" icon="spray-can">
    Solution or foam applied directly to the scalp. See the
    [Regaine (minoxidil) page](/library/medicines/regaine).
  </Card>

  <Card title="Dutasteride 0.5mg" icon="user">
    A more potent 5-alpha-reductase inhibitor. Reserved for specific
    cases, always under medical evaluation. See the
    [dutasteride page](/library/medicines/dutasteride).
  </Card>
</CardGroup>

An individualised, personalised compounded formulation — combining
finasteride, minoxidil, tretinoin, or other actives — is also something a
pharmacy can prepare after a medical prescription.

## How Hi-Doctor handles it

A licensed doctor decides case by case and never prescribes without
evaluation. Hi-Doctor's doctors review your hair growth questionnaire and
propose an EU-authorised alternative. See [how a consultation
works](/essentials/how-it-works), the [treatment areas](/essentials/treatments)
Hi-Doctor covers, and how eligibility is decided in
[safety](/essentials/safety).

## Sources

* AEMPS CIMA — ficha técnica Aldactone 100 mg (spironolactone, Spain)
* *Cureus* 2023 — Oral spironolactone in female pattern hair loss:
  systematic review and meta-analysis

## Start a consultation

<Card title="Hair-growth consultation" icon="stethoscope" href="https://hi-doctor.ai/consultation/hair-growth/1">
  Answer the hair-growth questionnaire and a registered doctor reviews it.
  They decide whether treatment is appropriate, which one, and at what dose —
  and declining is a normal outcome. See [what it costs](/essentials/pricing)
  and [how the review works](/essentials/how-it-works).
</Card>

<Warning>
  This page is reference information, not medical advice and not a prescription.
  Whether a medicine is appropriate for you is decided by a registered doctor
  after reviewing your consultation.
</Warning>
