Tolerance of spironolactone

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Abstract
A survey of 54 patients taking spironolactone for hirsutes or acne showed that side-effects occurred by 91%; in 80% patients, these were related to the anti-androgenic mechanism of the drug (menstrual disturbances, and breast enlargement and tenderness). The concomitant use of a contraceptive pill gave a lower incidence of menstural abnormalities. Only seven patients (13%) had to stop the drug. In a further eight patients, a reduction in dose to between 125 and 175 mg daily achieved a compromise of controlling the disease and the side-effects. Side-effects tended to occur early and so regular review during the initial 3 months of treatment is advised. Two patients in our study developed ''chloasma''-a previously unreported complication of spironolactone. This was the only side-effect which occurred late in treatment.

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