Spironolactone 100mg

This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains full information on potential medication interactions, side effects, and other important information you should know about the medicine before you start.

Instructions

You have stated that you wish to obtain treatment with Spironolactone to treat common symptoms of PCOS and perimenopause and menopause.

• Acne(1)
  • Your treatment length is 2 months, upon your 2 month check in from your provider, if medically eligible, your provider can increase your dosage to 100mg(2)
• Hair Loss(1)
  • Your treatment length is 2 months, upon your 2 month check in from your provider, if medically eligible, your provider can increase your dosage to 100mg(2)
• Excess facial hair growth
  • Studies show pairing birth control (1) (2) can better help to treat excess facial hair growth while the Endocrine Society (3) also reports contraceptives alone can be a great option, but are okay to be used in addition with antiandrogenic medication like Spironolactone.

You are to take one 100mg tablet daily. Spironolactone works by binding to and blocking androgen receptors on the skin and hair follicles to reduce acne, hair loss, and excess hair growth.

Individuals who can get pregnant should use a back up method while on Spironolactone. Review Pregnancy and Breastfeeding below for additional information.

Allergies

This medicine, like all medications, may cause an allergic reaction if you are allergic to similar medicines or components. If you are allergic to any of the following please do not take the medicine and call or message us or see your doctor in person.

• Spironolactone (Aldactone)
• Other potassium sparing diuretics
  
  

Conditions

We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop one of these conditions, please stop taking this medicine and call or message us immediately. This list may not be all inclusive.

• Heart failure
• Kidney failure
• Addison's disease
• Elevated potassium levels
• Electrolyte abnormalities
• Liver conditions
• Cirrhosis
• Frequent and chronic alcohol use
• Diabetes
• History of peptic ulcer disease
• History of a gastrointestinal bleed
  
  

Pregnancy and Breastfeeding

Spironolactone has hormonal effects that may impact male development during pregnancy. Studies in animals have shown that when Spironolactone was given to pregnant rats at high doses, it affected the normal development of male offspring. These effects included changes to the reproductive system and hormonal balance, some of which lasted into adulthood. Spironolactone's effects are due to its influence on hormones, including its ability to block testosterone. While these findings are based on animal studies, they highlight the importance of discussing any medications with your healthcare provider if you are pregnant or planning to become pregnant. (1)

Spironolactone is not present in breastmilk; however, limited data from a lactating woman at 17 days postpartum reports the presence of the active metabolite, canrenone, in human breast milk in low amounts that are expected to be clinically inconsequential. In this case, there were no adverse effects reported for the breastfed infant after short term exposure to Spironolactone; however, long term effects on a breastfed infant are unknown. There is no data on Spironolactone effects on milk production.

Intense diuresis can suppress lactation, however, it is unlikely that Spironolactone alone is sufficiently potent to cause this effect.

Medicines, Supplements, and Foods

We have evaluated the specific health information you provided us, however if you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan. Please ensure your chart is up to date with your current medications, allergies, and medical conditions so your provider can safely treat you as this list may not be all inclusive.

• Drospirenone containing birth control: Yaz (& generics), Yasmin (& generics), and Slynd
• Other potassium sparing diuretics
• ACE Inhibitors and other blood pressure medications
• NSAIDs
• Eplerenone
• Frequent and chronic alcohol use
• Digoxin
• Heparin
• Lithium
• Potassium supplements
  
  

Emergency Side Effects

This medicine can cause dangerous and potentially life-threatening side effects. If any of the emergency side effects listed in the manufacturer’s pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in person. This list may not be all inclusive.

• Sudden onset of chest pain
• Shortness of breath
• Difficulty or painful swallowing
• Severe skin rash and/or itching
• Facial or throat swelling
• Blurred vision
• Severe bloody diarrhea
• Gastrointestinal hemorrhage
• Post menopausal bleeding
  
  

Other Side Effects

This medicine can also cause other side effects including (this list is not all inclusive):

• Dehydration
• Headache
• Dizziness
• Fatigue
• Decreased libido
• Irregular menstrual cycles
• Vaginal spotting with initiating treatment
• Continued irregular vaginal bleeding with treatment
• Electrolyte changes
• Abdominal cramping, diarrhea, nausea, vomiting
• Nipple or breast pain
• Lower limb cramping
• Increased urination
• Breast tenderness
  
  

Risks

Accurate Information

We have evaluated your health history and your specific health information you provided and determined it is safe to proceed with this treatment at this time. If your health history changes including diagnoses or medications please message or call us before you take the medicine to ensure it's safe to proceed. Some medications and conditions can cause dangerous interactions with the medicine we are prescribing and we will help you evaluate that risk and decide on an appropriate treatment plan.

Treatment Failure

This treatment is not guaranteed to be effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency, call 911 or seek immediate medical help in person. You may need to seek alternative treatment such as those listed below or in the follow up plan.

Misdiagnosis or Delayed Diagnosis

Through telehealth, there is also a risk that we misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. This risk exists with a doctor in person as well but they may have additional resources to aid their evaluation. We use evidence-based practice and guidelines as well as clinical decision-making to minimize these risks.

Accepting or Declining Our Recommendation

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can’t provide. Message us or talk to your doctor in person to discuss alternative treatments.

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.

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