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Spironolactone Side Effects

For the Consumer

Applies to spironolactone: oral tablet

As well as its needed effects, spironolactone may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking spironolactone, check with your doctor immediately:

Incidence not known:
  • Abdominal or stomach cramping, burning, or tenderness
  • bleeding gums
  • bloody or black, tarry stools
  • bloody urine
  • breast pain
  • chest pain
  • chills
  • clay-colored stools
  • clear or bloody discharge from the nipple
  • cloudy urine
  • coma
  • confusion
  • constipation
  • convulsions
  • cough or hoarseness
  • dark urine
  • decrease in urine output or decrease in urine-concentrating ability
  • diarrhea
  • difficulty with swallowing
  • dimpling of the breast skin
  • dizziness
  • drowsiness
  • fast or irregular heartbeat
  • fever with or without chills
  • general feeling of tiredness or weakness
  • headache
  • heartburn
  • hives, itching, or skin rash
  • increased thirst
  • indigestion
  • inverted nipple
  • loss of appetite
  • lower back or side pain
  • lump in the breast or under the arm
  • muscle pain or cramps
  • muscle spasms or twitching
  • nausea and vomiting
  • painful or difficult urination
  • persistent crusting or scaling of the nipple
  • pinpoint red spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • redness or swelling of the breast
  • severe stomach pain
  • shakiness and unsteady walk
  • sore on the skin of the breast that does not heal
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swelling of the face, fingers, feet, ankles, or lower legs
  • swollen, painful, or tender lymph glands in the neck, armpit, or groin
  • tightness in the chest
  • trembling
  • troubled breathing
  • unpleasant breath odor
  • unsteadiness, trembling, or other problems with muscle control or coordination
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • vomiting of blood or material that looks like coffee grounds
  • weight gain
  • yellow eyes or skin

If any of the following symptoms of overdose occur while taking spironolactone, get emergency help immediately:

Symptoms of overdose:
  • Irregular heartbeat
  • nervousness
  • numbness or tingling in the hands, feet, or lips
  • rash with flat lesions or small raised lesions on the skin
  • reddened skin
  • weakness or heaviness of the legs

Minor Side Effects

Some spironolactone side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Incidence not known:
  • Burning feeling in the chest or stomach
  • hair loss or thinning of the hair
  • leg cramps
  • sores, welting, or blisters
  • stomach upset
  • swelling of the breasts or breast soreness in both females and males
  • unusual dullness or feeling of sluggishness

For Healthcare Professionals

Applies to spironolactone: compounding powder, 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]


1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Aldactone (spironolactone)." Searle, Skokie, IL.

It is possible that some side effects of spironolactone may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.