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Spironolactone Side Effects

Medically reviewed by Last updated on Oct 11, 2022.

Applies to spironolactone: oral suspension, oral tablets.

Side effects include:

Most common adverse effect (incidence >5%): Gynecomastia.

Other adverse effects: Hyperkalemia; hypotension; worsening renal function; hyponatremia; hypomagnesemia; hypocalcemia; hypochloremic alkalosis; hyperglycemia; impaired neurologic function/coma in patients with hepatic impairment, cirrhosis and ascites.

For Healthcare Professionals

Applies to spironolactone: compounding powder, oral suspension, oral tablet.


The most common adverse effect was gynecomastia.[Ref]


Very common (10% or more): Gynecomastia (13%)

Frequency not reported: Breast disorders in women, slight androgenic effects, breast tenderness in women, voice deepening in women, breast pain[Ref]


Common (1% to 10%): Hyperkalemia, hyponatremia

Uncommon (0.1% to 1%): Acidosis in patients with liver problems

Rare (less than 0.1%): Dehydration, porphyria, hyperuricemia

Frequency not reported: Reversible hyperchloremic metabolic acidosis in patients with decompensated hepatic cirrhosis, electrolyte disturbances[Ref]


Common (1% to 10%): Changes in vaginal secretions, amenorrhea, postmenopausal bleeding

Frequency not reported: Reproductive system disorders, erectile dysfunction, impotence, menstrual disorders[Ref]

Nervous system

Common (1% to 10%): Lethargy in patients with cirrhosis, paresthesia

Rare (less than 0.1%): Paralysis, paraplegia of the limbs due to hyperkalemia

Frequency not reported: Headache, drowsiness, dizziness, ataxia[Ref]


Common (1% to 10%): Nausea, vomiting

Very rare (less than 0.01%): Gastric inflammation, gastric ulcers, intestinal hemorrhage, cramps

Frequency not reported: Digestive system disorders, diarrhea, indigestion, gastric bleeding[Ref]


Common (1% to 10%): Libido reduced in women

Uncommon (0.1% to 1%): Confusion

Frequency not reported: Libido reduced in men[Ref]


Common (1% to 10%): Malaise

Very rare (less than 0.01%): Breast cancer[Ref]


Common (1% to 10%): Weakness

Frequency not reported: Fatigue, fever[Ref]


Uncommon (0.1% to 1%): Rash, urticaria, erythema, chloasma, pruritus, exanthema

Rare (less than 0.1%): Eczema

Very rare (less than 0.01%): Alopecia, erythema annulare centrifugum, hypertrichosis

Frequency not reported: Hirsutism, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS), maculopapular or erythematous cutaneous eruptions[Ref]


Uncommon (0.1% to 1%): Muscle spasms, leg cramps

Very rare (less than 0.01%): Systemic lupus erythematosus, osteomalacia[Ref]


Uncommon (0.1% to 1%): Serum creatinine elevated

Rare (less than 0.1%): BUN increased

Very rare (less than 0.01%): Acute renal failure

Frequency not reported: Renal dysfunction[Ref]


Rare (less than 0.1%): Thrombocytopenia, eosinophilia, leukopenia

Frequency not reported: Agranulocytosis[Ref]


Rare (less than 0.1%): Hypersensitivity

Frequency not reported: Anaphylactic reactions[Ref]


Very rare (less than 0.01%): Vasculitis

Frequency not reported: Mild hypotension[Ref]


Very rare (less than 0.01%): Hepatitis

Frequency not reported: Mixed cholestatic/hepatocellular toxicity[Ref]

Frequently asked questions


1. Product Information. Aldactone (spironolactone). Searle. 2001.

2. Cerner Multum, Inc. UK Summary of Product Characteristics.

3. Cerner Multum, Inc. Australian Product Information.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.