Spironolactone provides significant advantages to those with heart failure as well as fluid retention from liver cirrhosis and kidney disease. Spironolactone may reduce the likelihood of death from any cause and from heart disease by nearly 30% especially among those where the heart pumps less than 35-40% of blood filling the left ventricle. Experts assume spironolactone also benefits those with less serious degrees of heart failure.

Spironolactone, originally thought of only as a potassium sparing diuretic, also counteracts the action of male hormone. This basically limits its chronic use to women but opens new therapeutic vistas. Spironolactone combats acne, reduces excessive scalp hair loss common in middle aged women and even diminishes unwanted terminal hair from the face, body and arms.

Spironolactone elevates blood potassium especially when kidney malfunction exists; caution is required as too much potassium may lead to cardiac issues. Spironolactone regularly leads to enlargement and tenderness of the breast in both men and women. This is a dose and time dependent phenomenon generally reversible several months after discontinuing the drug. Spironolactone also causes menstrual irregularities and excessive uterine bleeding. Pregnancy should be avoided while on therapy.