Can You Drink Alcohol While Taking Spironolactone for Acne? Safety Tips

Can You Drink Alcohol While Taking Spironolactone for Acne?

Spironolactone is a medication that has been used to treat high blood pressure since the 1960s. However, in recent years, dermatologists have increasingly prescribed spironolactone off-label to treat acne in women. As an androgen blocker, spironolactone can be highly effective at reducing excess sebum production and inflammation associated with hormonal acne. But can you still drink alcohol while taking spironolactone for acne treatment? Here's what you need to know.

How Spironolactone Works for Acne

Acne is driven by excess sebum production, inflammation, and the growth of bacteria like Propionibacterium acnes. Hormones called androgens stimulate sebum production and inflame acne. Testosterone is the main androgen, but its more potent form dihydrotestosterone (DHT) plays an even bigger role in acne.

Women with hormonal acne tend to have higher levels of androgens. Spironolactone blocks androgen receptors, preventing them from triggering excess sebum and inflammation. It also directly reduces testosterone production in the ovaries and weakens androgen activity throughout the body.

With less DHT and testosterone activity, the sebaceous glands produce less oil. Inflammation goes down. Spironolactone helps restore hormonal balance in women with acne, providing significant clearing within 2-3 months in many cases.

Is It Safe to Drink Alcohol with Spironolactone?

Most experts consider it safe to drink alcohol in moderation while taking spironolactone for acne. There are no known drug interactions between spironolactone and alcohol. However, there are some important factors to consider.

Dehydration and Dizziness

Alcohol is a diuretic, meaning it increases urine production and fluid loss. Spironolactone is also a diuretic due to its effects on the kidneys. Taking both together can potentially lead to dehydration, electrolyte abnormalities, and a drop in blood pressure.

This may result in symptoms like:

• Dizziness
• Lightheadedness
• Weakness
• Fast heart rate

To reduce this risk, make sure to drink water in between alcoholic beverages. Avoid excessive intake of alcohol while on spironolactone.

Reduced Tolerance

Some research indicates spironolactone may reduce alcohol tolerance. In a 1986 study, patients taking spironolactone experienced greater impairment from alcohol compared to controls. Blood alcohol levels were also higher.

The exact mechanism is unknown. But it's possible that changes in fluid balance contribute to this effect. Lowered tolerance would increase the intoxicating effects of alcohol.

If you find yourself getting drunk faster when you start taking spironolactone, be mindful of pacing yourself. You may need to cut back on the number of drinks you have.

Worse Hangover Symptoms

Hangovers after drinking tend to be worse when taking spironolactone, according to anecdotal reports. Patients cite more fatigue, headache, nausea, and dizziness than normal.

This seems to be related to dehydration and electrolyte disturbance. Alcohol plus spironolactone leads to more fluid loss, which can leave you both dried out and depleted of minerals like potassium, magnesium, and sodium.

To help avoid miserable hangovers, be diligent about hydrating and consuming electrolytes while drinking. Coconut water, bone broth, and electrolyte sports drinks can help replenish your body after a night of drinking.

Increased Drowsiness

Spironolactone may cause drowsiness as a side effect. Combining it with alcohol, another depressant, can exacerbate this effect. You may feel very sleepy after just a drink or two.

Try to avoid operating vehicles or machinery if you feel overly tired after drinking alcohol with spironolactone. Be cautious about falling asleep in situations where you could get hurt.

Avoiding Adverse Effects

Here are some tips for minimizing problems if you want to drink alcohol while taking spironolactone:

• Stay well-hydrated with water before, during, and after drinking
• Consume electrolytes to maintain fluid and mineral balance
• Pace yourself - drink slower since tolerance may be reduced
• Eat enough food before or while drinking to avoid low blood sugar
• Limit alcohol intake - no more than 1-2 drinks per day
• Avoid other diuretics like caffeine or herbal teas near bedtime
• Take spironolactone earlier in the day if drinking at night

Being mindful of these precautions will allow you to enjoy an occasional drink without worrisome interactions with spironolactone. Severe adverse effects are rare if intake is moderate.

Contraindications to Any Alcohol Use

In some cases, it's best to avoid alcohol completely while taking spironolactone:

• If you've had an allergic reaction or other issues with spironolactone in the past
• If you have kidney disease or reduced kidney function
• If you have liver disease, cirrhosis, or hepatitis
• If you have been advised by your doctor not to consume alcohol for any reason
• If you have a history of alcohol misuse or addiction

Consuming alcohol could potentially worsen side effects or health risks if you have certain underlying conditions. Your dermatologist or primary care doctor can provide guidance if you have concerns.

Possible Interactions with Other Acne Medications

Spironolactone is often combined with other prescription or over-the-counter (OTC) acne treatments. Below are some things to keep in mind about using alcohol alongside these other medications:

Oral Antibiotics

Oral antibiotics like doxycycline, minocycline, and tetracycline are commonly prescribed with spironolactone for acne. There are no known major interactions between these antibiotics and alcohol.

However, antibiotics carry their own side effects like sun sensitivity, yeast infections, and stomach upset. Consuming alcohol could potentially worsen antibiotic-related nausea, diarrhea, or dizziness in some people.

Isotretinoin (Accutane)

The powerful acne drug isotretinoin (Accutane) can interact with alcohol, so avoid drinking any amount if taking this. Combining the two raises the risk of adverse effects on the liver as well as severe headaches, nausea, and flushing.

Topicals

Using acne creams or gels like benzoyl peroxide, tretinoin, adapalene, sodium sulfacetamide, or clindamycin along with oral spironolactone poses no issues. However, be aware that combining certain products can cause dryness, peeling, irritation, and skin sensitivity.

Drinking while using potentially drying topicals may potentially worsen any alcohol-related dehydration and hangover symptoms.

OTC Meds

There are no significant interactions between spironolactone and common OTC meds like ibuprofen (Advil) or acetaminophen (Tylenol). Small amounts of alcohol (1 drink) are also okay with most OTCs. However, excess drinking can increase the liver risks from acetaminophen.

Talk to Your Doctor

Always check with your dermatologist before drinking alcohol while taking any acne medications. Underlying health factors may impact whether it's safe and how much alcohol is advisable. Your doctor

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.