Spironolactone for Hidradenitis suppurativa
This page provides information about Spironolactone for Hidradenitis suppurativa
Using spironolactone for HS
Women naturally produce small amounts of male hormones, such as testosterone and dihydrotestosterone (DHT). Spironolactone is a medicine that blocks the effects of these hormones called androgens. Although it is licensed for conditions such as high blood pressure and fluid retention, it is commonly used ‘off label’ to treat HS in women.
‘Off licence’ means the medicine is not specifically licensed in the UK to treat this condition. However, it is available on the NHS and is a good alternative to antibiotics, particularly for women whose HS worsens around their menstrual cycle.
Spironolactone will not cure all HS but may help:
- Reduce the number of HS flare-ups
- Decrease pain and inflammation • Reduce new nodules and abscesses
- Improve quality of life.
It works slowly. Most women notice an improvement after 3 months, but it may take up to 6 months to see the full effect.
What dose should I take?
The usual dose is between 50 milligrams (mg) and 200 mg once a day.
You will usually start by taking 50 mg once a day for one month.
If you have no side effects and your blood tests are normal, your healthcare professional may increase your dose to:
- 100 mg once a day for one month • 150 mg once a day for one month
- up to the maximum recommended dose of 200 mg once a day
What are the common side effects of spironolactone?
Side effects of spironolactone may depend on the dose which is taken.
Common side effects
- Sore or swollen breasts
- Irregular menstrual periods, which may improve if you take the pill or use a hormonal device within the uterus (IUD).
- Drop in blood pressure (Postural hypotension) can make you feel dizzy, lightheaded or faint.
Uncommon side effects
- Skin rashes
- Drowsiness
- Fatigue
- Headache
- Loss of sex drive
Rare side effects
- Confusion
- Loss of coordination
- Increased urine production, this medicine is a diuretic (water tablet)
Very rare side effects
- High potassium levels in the blood (more likely if you are over 45 or have heart/kidney problems).
- Changes in blood tests for your kidneys or liver (these usually go back to normal if you stop or lower the dose).
- Cancer Animal studies showed a possible link to cancer at very high doses, but this has not been seen in people using regular doses.
Important precautions
- Do not take spironolactone if you are pregnant or trying to get pregnant.
- Do not take spironolactone if you have Addison’s disease or serious kidney problems.
- Drinking alcohol may increase some of the side effects of spironolactone, such as dizziness.
- We advise decreasing the amount of alcohol you consume.
- Use reliable contraception while using spironolactone
- The combined pill can help reduce side effects and improve acne.
- It is usually safe to try for a baby one month after stopping spironolactone.
How will I be monitored for the side effects of spironolactone treatment?
Your doctor will recommend a blood test to check your potassium level before starting treatment. They may also monitor your bloods during treatment. These checks may be needed more frequently if you have heart or kidney problems, or if you take other medications that affect potassium levels.
Can I take other medicines with spironolactone?
Please tell your doctor if you take any of the following medicines or supplements:
- Angiotensin-converting-enzyme (ACE) inhibitors, used to treat high blood pressure or heart problems, such as quinapril, captopril, perindopril.
- Anti-inflammatory painkillers, such as aspirin, ibuprofen, diclofenac.
- Antibiotics, such as trimethoprim, trimethoprimsulfamethoxazole)
- Water tablets, also called diuretics, such as furosemide, indapamide, bumetanide.
- Medicines for heart conditions, such as digoxin.
- Medicines for high blood pressure, such as candesartan, losartan, olmesartan.
- Potassium supplements
If you are taking a medication that is not listed above, please inform your doctor. There may be other medications or supplements that can interact with spironolactone and cause problems.