Spironolactone is not known to cause weight gain, and most people will not see the scale go up because of this medication. When weight changes happen, they are usually linked to fluid shifts or to the health condition being treated, rather than spironolactone itself. Learn more about unexplained weight gain and why it can happen.
Because spironolactone works as a diuretic, it can help the body get rid of extra fluid. This may lead to a small, temporary drop in water weight, especially in people who retain fluid. If weight increases quickly over a few days and comes with swelling in the legs, feet, or belly, it may be a sign of fluid buildup that needs medical attention.
Spironolactone is also used in some cases for hormone-related acne, and the side effects described for this use typically include things like irregular periods, breast tenderness, dizziness, and fatigue, not weight gain. If someone notices steady weight gain while taking it, it is worth reviewing diet, sleep, stress, and any other medications, since these are common reasons weight changes happen during treatment.
A doctor or pharmacist should be told about any unexpected or rapid weight change, especially if there is swelling, shortness of breath, or reduced urination. Spironolactone should not be started, stopped, or dose-adjusted without guidance, and it is important to avoid self-medicating with “water pills” or herbal diuretics because they can be unsafe when combined with prescription diuretics. For ongoing concerns, a primary care provider can help, and a cardiologist, nephrologist, or dermatologist may be the right specialist depending on why spironolactone was prescribed.