Pregnancy
Available animal studies showed that spironolactone may affect the development of the male embryo.
Rat studies reported feminization of male fetuses, as well as hormone dysfunction in females exposed to spironolactone in the uterus.
Limited data shows that there may be additional risks to the mother from spironolactone use during pregnancy associated with heart failure, cirrhosis, and poorly controlled hypertension. There may also be additional risks to the fetus associated with the development of the cardiovascular system.
Because of the potential risk to the male fetus, in addition to other potential risks, pregnant women, or women who may become pregnant, are advised to avoid spironolactone.
Breastfeeding
Spironolactone is not present in breast milk. However, limited data shows the presence of the active metabolite, canrenone, in human breast milk in low concentrations. Based on limited evidence, there were no adverse effects reported for the breastfed infant after short-term exposure to spironolactone, but long-term effects on a breastfed infant are unknown.
There is no data on spironolactone regarding milk production.
Therefore, a woman and her doctor should make a decision whether to discontinue breastfeeding before starting spironolactone, taking into account the importance of the drug to the mother and potential harm to the nursing infant.
References
- Medlineplus.gov. (2024). Spironolactone. MedlinePlus Drug Information. [online] Available at: https://medlineplus.gov/druginfo/meds/a682627.html [Accessed 10 Oct. 2024].
- Ncbi.nlm.nih.gov. (2024). Spironolactone. Available at: https://pubmed.ncbi.nlm.nih.gov/28024992/. [Accessed 10 Oct. 2024].
- Epocrates.com. (2024). Spironolactone. Available at: https://online.epocrates.com/drugs/282/spironolactone. [Accessed 10 Oct. 2024].
- Uptodate.com. (2024). Spironolactone. Available at: https://www.uptodate.com/contents/acne-vulgaris-management-of-moderate-to-severe-acne?search=spironolactone&source=search_result&selectedTitle=1~147&usage_type=default&display_rank=1#H1915349456. [Accessed 10 Oct. 2024].
- Medicines.org.uk. (2024). Spironolactone. Available at: https://www.medicines.org.uk/emc/product/2898/smpc. [Accessed 10 Oct. 2024].
- DailyMed (2024). Spironolactone. Available at: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c23b6b9b-aec3-48a8-a518-76e4097f6479 [Accessed 10 Oct. 2024]