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Dermbits

What dose of spironolactone do you typically use in your acne patients?

Acne

You. So when I start a patient on oral spironalactone, I do tend to start on the lower end because we can always go up. Especially I might start patients a little bit lower. If they're a patient that doesn't intake a lot of fluids, like water during the day, or if it's somebody who does a lot of cardio exercise and they're sweating a lot during the day, then I might be more worried read about the additive diuretic effect of the spironalactone, and I might be more concerned about them developing perhaps some orthostatic hypotension. So in my patients who tell me they're not great water drinkers or they are running a lot during the day, I might start them on the lower end, even sometimes as low as 25 milligrams a day, although my usual dose for those patients is 25 milligrams bid. Do have some patients that I start at 50 milligrams bid. It just depends on their level of comfort, also with the medication and also if they do a lot of cardiovascular exercise, are sweating a lot, don't have a lot of water intake. I might start them on the lower end and then reassess in a few months and potentially increase.