Monday Pharmaceutical Mystery: April 13

Why is spironolactone prescribed by a dermatologist for a young woman with no indications of edema?

You are a retail pharmacist verifying medications. You notice that a dermatologist has prescribed spironolactone. You wonder if spironolactone is within his scope of practice since spironolactone is most commonly known as a diuretic.

The patient is a 24 year old female on norgestrel-ethinyl estradiol tablets (Lo/Ovral), and albuterol MDI 2 puffs q4h prn exercise induced asthma. She is allergic to doxycycline and tetracycline.

Mystery: Why is this drug being prescribed by a dermatologist for a young woman with no indications of edema?

Solution: It is being used to treat acne. Spironolactone is an androgen receptor antagonist and has been shown to reduce sebum production. Spironolactone is a nonantibiotic alternative to traditional systemic treatments for women with acne.

REFERENCE

Charny JW, Choi JK, James WD. Spironolactone for the treatment of acne in women, a retrospective study of 110 patients. Int J Womens Dermatol. 2017;3(2):111—115. Published 2017 Mar 13. doi:10.1016/j.ijwd.2016.12.002