Aldactone or Spironolactone
 

Has anyone been on Aldactone or spironolactone? I have been prescribed it for excess hair growth {hirsutism} as my hormones are out of wack. It is actually a high blood pressure medication. I was tested for PCOS by ultrasound and I dont have any cysts, but seem to have alot of the other symptoms....

:wave: Akiwican

Just checkin'...
 

Hi Lesley,

You probably know this, but remember that Aldactone is potassium sparing so be very cautious about taking any potassium supplements.

Hope it helps yer hormones!

Roz

Potassium
 

Yes thanks Roz, I just read that in a search on here. I really haven't decided if I will take it or not? I mean, the hair growth bothers me {thank god alot of it is blonde} but is it worth it to take a blood pressure medication in the long term for a vanity thing? I just wondered if anyone had good/bad experiences with it......

:wave: Lesley

I take aldactone and it is a diuretic it is used for that more than blood pressure because the effects on blood pressure is very minimal. I started it last November and I have felt very good, and there is a visible change in my hair growth. It is finer, lighter grows back slower and more normal. I have never had that at all.
I also started glucophage for insulin resistance and I noticed a decrease in cravings of carbs right off. Before I started "lowcarbing" I was doing it on my own.
I take the lowest dose of aldactone and I dont' want to increase it very much at all. You do have to be careful with potassium intake but I have been okay there too. I'm monitored every 4 to 6 months now to see how things are going. Make sure you increase the amount of water you would normally drink to make up for the effects of the diuretic so you stay hydrated and becareful with ketones because that can be harder on the kidneys.
Tanya

Thankyou
 

Hi Tanya

Just curious as to what dosage you are taking? Did your Dr prescribe it for the hirsutism problem specifically? Have you seen a decrease in hair everywhere ? Have you noticed any side effects {bad} or benefits to taking aldactone?

:wave: Lesley

Yes I'm taking it for the Hirutism specifically. Many years ago the first doctor put me on a pill (demulen) that was also suppose to help the hair issue. I never saw the results for the year of being on that as I have on the aldactone in the past 8 months.
I'm on 25 mg. I refuse to take any higher since it seems to work well for me. My doctor said that it helps in about 60% of cases and you should be able to start seeing a difference in just a few weeks, somewhere around 6 to 8 I think up to about 3 months.
I have noticed a difference everywhere except for my head, I have very thick hair and the only thing that ever effected that was a low protein diet.
As for side effects the only thing I notice and you would notice this with any diurectic including caffeine is that I use the restroom more in the morning but on this low dose it doesn't last very long.
I haven't noticed anything else that concerns me at this time. I will eventually drop it because I don't like taking prescriptions but since I'm trying to heal my body I'm willing to take the risk. Obviously something is working right for testosterone to not be effecting my hair growth.
Tanya

From what my Dr said I would have to be on it continuously to control the hair growth. If I stop the hormone level will increase and so will the hair. Thats part of the reason I am hesitant to start it. I also hate taking pills and the thought of taking them on the long term does not appeal to me much. He has prescribed 100mg for me.. .thats 4 times what you are on!

Sounds like you have had good results so far. He also said that I might get spotting and irregular periods. Has that happened to you? I know you have PCOS so it might affect you differently? I was recently tested for that {ultrasound} as I have many symptoms but i dont have it.

:wave: Lesley

The only time I have spotting is when I don't take my BCP properly, like being late taking one or missing it.
You are on a very high dose and I wouldn't think you would need that much. My doctor started me on the low dose and was willing to increase it if it didn't work. I would insist on the lowest dose and go from there if you feel like taking it. there is no sense in taking more if you don't need it.
I never had lab results that specifically said that I have the disorder but I have all the symptom of it. Give me a check list and I can check about every symptom there is.
I also seem to have darker hair growth than you do. Even on my upper lip it is very dark and at least now it comes in fine and lighter so it is easier to remove.
I'm not sure what exactly to tell you, other than my experience as a nurse is always the lowest dose and move up if you think you need to. 100 mg of aldactone is a lot.
I'm also 5'3 (a little shorter) and weight right now about 195, I have lost about 27lbs in the past 15 months.
Tanya

Thanks again
 

Sorry to bug you with all these questions.... I didnt know you were a nurse :thup:

I have already looked into PCOS quite throughly and seem to have alot of the symptoms but since nothing showed up on the ultrasound {cysts} he said I dont have it. Thats why I went on to have further tests done {thryoid, insulin} and all came back normal. {results posted in thyroid forum} Only my hormones {male} were out of wack.

Yes, I am very grateful that my hair is mainly fair coloured, but the few dark, course ones really bug me on my face, people stare.... :(

Maybe I could cut the pills in half? i.e. 50 mg and try that. Would that reduce the effectiveness? I really dont want to go on the waiting list to go back and see him. He is in another city and I had to wait weeks to see him last time... then 6 weeks for the results to come back. Maybe he thought that 100 mg was good for an initial shock to my system and then reduce the doseage next time?

Thanks very much for helping me with this Tanya.

:wave: Lesley

I had never heard of aldactone for this purpose until I went to my doctor this past year. I'm not sure what to tell you on the dosage I would think 50mg would be more reasonalbe that 100mg. My best advice at the moment would be to do several searches on the web with aldactone and PCOS as the search words. Perhaps you could find some suggestions from other doctors online. I would also check around for other doctors opinions in the area. I know it is a pain, but the higher increase in male hormones is a great indicator of PCOS and you don't absolutely have to have cysts seen on ultrasound. The cysts of PCOS and ovarian cysts are two very different things. PCOS is still a very underestimated syndrome and you need a doctor that will really adress it with you and not treat you as it is not a problem. If you indeed have the syndrome I would venture a guess that you do, you need someone that will work with you when you are so willing to heal yourself.
Just my 2 cents worth.
Don't start taking anything until you feel like that it is right for you.
This happened to be the right thing for me, but my goal has been to heal and get my health back. You may have different ways of trying to get there, but if it works for you more power to you. Medicine can be very benefical but it can also have it's draw backs as well so you are very correct in being careful, asking questions to make the best informed choice you can.
I also use surgicream to remove my hair on my face, and I'm looking at buying something I saw on qvc one time. I have to wait for some money to do so.
Tanya

I forgot to mention one other thing about aldactone. When you are on it you can not take NSAIDS (nonsteroid anti-inflamitory drugs), these are Ibuprofen(advil, motrin), asprin, aleve, any of those type of pain killers. They all effect the kidneys, I get migrains fairly frequently and even one Ibuprofen can cause me to swell up. The pharmasist told me that occasional use is okay but not frequent, I prefer to avoid them all together.
Tanya

Thanks
 

For the heads up on that one Tanya. I very rarely take any sort of pain killer... dont seem to need them. I should also stop my Potassium suppliments right?

:wave: Lesley

Yes stop the potassium, aldactone is potassium sparing so you have to be very careful there, my doctor always asks if I'm eating banana's(yuck), or orange juice because they are both high in potassium. So far my levels have been fine.
Tanya

Got it
 

Picked up my prescription tonight and found out that I am supposed to take 150 mg per day! :eek: 1/2 a 100 mg tablet three times a day! :eek: This is going to be hard... I hate taking pills. :( Do you take it 3 times a day? I guess that ensures a steady stream of medication...

How often do you get your potassiuim levels checked Tanya?

:wave: Lesley

G'day Lesley,

Found a bit more info about dosage...

"Treatment protocols may involve continuous spironolactone use at 50mg to 200mg per day or cyclic use. For example 50mg or 100mg twice daily from the 4th to the 22nd day of the menstrual cycle. Numerous treatment protocols involving spironolactone have been used in different studies, but no particular treatment approach has been shown to be significantly superior. Combination therapy with an oral contraceptive pill or dexamethasone appears to have an improved beneficial effect on hirsutism and limits side effects.

Spironoolactone is a diuretic, so it's advised to drink plenty of water while taking it. Side effects with spironolactone are generally transient. As with all antiandrogens , spironolactone use should be avoided during pregnancy and in women who have a family history of breast cancer, although there is no proven association between spironolactone and breast malignancy."
http://www.hairfacts.com/methods/rxoral.html

and...

"iii) Spironolactone (Aldactone®) was originally marketed as a diuretic, but has limited uses in that field. Its efficacy as an antiandrogen was noticed through its ability to decrease testosterone production, increases the rate of testosterone metabolism, to inhibit dihydrotestosterone binding to the androgen receptor and to retard the conversion of testosterone to dihydrotestosterone by its effect on 5 a - reductase. Spironolactone is a stronger antiandrogen than cyproterone, but also has progestational effects. The dosage is 50 - 100 mg. by mouth twice a day. Cyproterone acetate is taken up in adipose tissue and then slowly released, thus rendering the patient susceptible to menstrual irregularity. A reversed sequential regimen was developed to avoid this side effect. It consists of giving cyproterone acetate on days 5 though 15 of the cycle in doses initially of 50 to 100 mg. per day. Ethynyl estradiol is given in a dose of 50 µg daily from days 5 through 26 of the cycle. Dose reduction is possible once effective remission of hirsutism occurs. A combination oral contraceptive (Diane) containing cyproterone acetate (2 mg.) and estrogen ethinyuloestradiol (50 µg) is sometimes used for maintenance. Side effects include nausea, fatigue, irregular menses, and headache. Because of its previous use as a diuretic, high serum potassium and low blood pressure have been postulated, but do not occur in practice. Spironolactone like cyproterone interrupts the masculinization of a male fetus so contraception should be practiced by a woman previously infertile with polycystic ovarian disease as ovulation has been induced with spironolactone."
http://www.electrology.com/jour93h.html

and...

"Female Hirsutism 100mg to 200mg daily in divided doses is usual however 50mg daily has also been shown to be effective.

Clinical improvement is usually shown within 3 to 6 months and an initial course of treatment should continue for 12 months.

ALDACTONE may be administered continuously or as a cyclical dosage for approximately three weeks out of every four. Dosing from day 5 to 21 of the menstrual cycle, with a drug free interval during menstruation has been effective.

Cyclical dosing may reduce menstrual irregularities in women with previously regular cycles.

Combined use with oestrogen-progestogen oral contraceptives may also be considered to provide both regular menstrual cycles and adequate contraception."
http://www.medsafe.govt.nz/Profs/Da...ldactonetab.htm


That's a long way of saying I think your doctor is right - but maybe in the future you'll be able to lower your dosage.

I would suggest (and I'm sure Tanya will agree) that you go back to your doc after a week or so and get your potassium level checked.

HTH!

Roz