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Spironolactone also commonly and dose-dependently produces gynecomastia (breast development) as a side effect in men. [ 110 ] [ 129 ] [ 131 ] [ 132 ] At low doses, the rate is only 5 to 10%, [ 132 ] but at high doses, up to or exceeding 50% of men may develop gynecomastia.
A study found that oral spironolactone had "about 10 to 20% of the feminizing effect of cyproterone acetate" on sexual differentiation in male rat fetuses, with a dose of 40 mg/day spironolactone having an effect equal to 1–3 mg/day cyproterone acetate. [35] [36]
Dosage typically includes information on the number of doses, intervals between administrations, and the overall treatment period. [3] For example, a dosage might be described as "200 mg twice daily for two weeks," where 200 mg represents the individual dose, twice daily indicates the frequency, and two weeks specifies the duration of treatment.
26 percent of women age 40 through 49. 15 percent of women over 50. ... Spironolactone: ... Its effects on hormones are so pronounced that it is not recommended for treating acne in men because of ...
[12] [13] Due to its activity as an androgen receptor antagonist and progesterone receptor agonist, spironolactone causes adverse effects, including gynecomastia or decreased libido in males and menstrual abnormalities in females. [14] Spironolactone also causes hyperkalemia [15] and renal insufficiency. [16]
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The trial was stopped early because the beneficial effect of spironolactone on all-cause death exceeded the prespecified discontinuation requirements. Spironolactone reduced the risk of death by 30% compared to placebo. Additionally, there was a 35% reduction in the risk of hospitalization for worsening heart failure in the spironolactone group.
[152] [148] [161] For these reasons, bicalutamide has replaced spironolactone in the treatment of the condition. [100]: 2139 For comparison to bicalutamide, a higher dosage of spironolactone of 5 mg/kg (or about 100 to 150 mg in boys that are 20 to 30 kg or 45 to 65 lbs) once daily is recommended for use in male peripheral precocious puberty.