Sebocyte Androgen Receptor Antagonist & Aldosterone Blocker • Rx

Spironolactone

Brand Reference: Aldactone

Medically Reviewed by Dr. Priya Nair, MD, FAAD (NPI #1295730425)
90.80%
Patient “Worth It”
43 verified logs
$5.30
Lowest Monthly Cash

Spironolactone Clinical & Real-World Cost Fact Matrix

Metric Verified Benchmark Source
Spironolactone RxNorm Concept ID 9997 U.S. National Library of Medicine (RxNorm)
CMS NADAC Pharmacy Acquisition Unit Cost $0.0450 / unit CMS Medicaid NADAC Weekly Feed
Walk-In Chain Pharmacy Cash Average $24.00 / mo CMS NADAC + U.S. Retail Markup Index
Mark Cuban Cost Plus Wholesale Price $5.30 / mo Cost Plus Drugs Wholesale Feed
Community Mean Out-of-Pocket Paid $6.50 / mo 43 Zero-PHI Verified Patient Logs
INSTANT PRESCRIPTION & CASH ROUTING

Verified Online Prescribers & Wholesale Pharmacies for Spironolactone

DotMD Club Members get $29 flat-rate script renewals →
Mark Cuban Cost Plus Drugs (Wholesale Pharmacy)
Requires an existing doctor prescription. Need a script? Pair with a $29 DotMD Club TeleMed consult.
$5.30/mo
Wholesale Cash Price
View Wholesale Rx →
Ro Body & Metabolic Clinic (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days
$ 45.00
Consult / Starting Tier
Start Online Visit →
Midi Health Perimenopause & HRT Clinic (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days
$ 59.00
Consult / Starting Tier
Start Online Visit →
Hims & Hers Direct Cash Pharmacy (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days • Rx included in monthly tier
$ 49.00
All-In Monthly
Start Online Visit →
Sesame Direct Cash-Pay Prescriber Network (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~1 days
$ 29.00
Consult / Starting Tier
Start Online Visit →

Spironolactone Clinical Pharmacology & DailyMed Monograph

RxCUI 9997 • NDC 00378-2145-01

Competitively blocks dihydrotestosterone binding at cutaneous sebocyte and female scalp follicular androgen receptors while inhibiting 17-alpha-hydroxylase—clearing hormonal jawline/chin cystic acne and female-pattern hair thinning without antibiotic resistance.

Classified under Sebocyte Androgen Receptor Antagonist & Aldosterone Blocker (Rx), Spironolactone exhibits a $18.70/month gap between standard U.S. retail cash counters ($24.00) and verified direct-to-patient routing ($5.30) anchored to $0.0450 CMS unit cost.

Pharmacokinetic profiling of Spironolactone demonstrates an elimination half-life of 1.4 hours parent / 16.5 hours active canrenone & 7-alpha-thiomethylspironolactone with ~73% oral (enhanced 95% with food) systemic bioavailability; clearance proceeds via hepatic deacetylation and dethioacetylation to active sulfur metabolites, reaching clinical onset within 6–12 weeks sebum suppression and acne clearance.

Titration schedules for Spironolactone (25 mg PO daily → 50 mg PO daily → 100 mg PO daily (or 50 mg BID) → 150–200 mg PO daily (female alopecia)) require excluding pregnancy (feminization of male fetus); hyperkalemia (> 5.2 meq/l); addison disease; real-world patient logs highlight intermenstrual spotting (at >=100 mg) (22% of reports), diuretic urination (19% of reports), breast fullness (14% of reports) alongside a 90.80% Worth-It consensus.

Half-Life
1.4 hours parent / 16.5 hours active canrenone & 7-alpha-thiomethylspironolactone
Bioavailability
~73% oral (enhanced 95% with food)
Metabolism & Clearance
Hepatic deacetylation and dethioacetylation to active sulfur metabolites
Clinical Onset
6–12 weeks sebum suppression and acne clearance

Standard Adult Titration & Dosages

25 mg PO daily 50 mg PO daily 100 mg PO daily (or 50 mg BID) 150–200 mg PO daily (female alopecia)

Absolute & Relative Contraindications

  • Pregnancy (feminization of male fetus)
  • Hyperkalemia (> 5.2 mEq/L)
  • Addison disease

Logged Side-Effect Incidence (43 Reports)

Intermenstrual spotting (at >=100 mg) 22%
Diuretic urination 19%
Breast fullness 14%

Spironolactone Patient Dosage Logs & Out-of-Pocket Cost Ledger

Across 43 verified cash-pay logs, Spironolactone achieves a 90.80% Worth-It rating with out-of-pocket spend averaging $6.50/mo versus $24.00/mo walk-in retail.

15-Second Anonymous Micro-Log (Zero-PHI Architecture)

Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.

Effectiveness: 5/5 • Worth It Dosage: 25 mg PO daily • Paid: $4.66/mo via Cost Plus Drugs
Intermenstrual spotting (at >=100 mg)

Switched to Cost Plus Drugs at 25 mg PO daily for Spironolactone; monthly out-of-pocket dropped to $4.66 compared with $24.00 retail.

Effectiveness: 5/5 • Worth It Dosage: 50 mg PO daily • Paid: $5.41/mo via Cash Clinic

Completed 10 weeks on Spironolactone (50 mg PO daily). Zero notable side effects on steady dosing.

Effectiveness: 4/5 • Worth It Dosage: 100 mg PO daily (or 50 mg BID) • Paid: $6.15/mo via Cost Plus Drugs
Breast fullness

Consistent biomarker response on 100 mg PO daily (or 50 mg BID) Spironolactone sourced via Cost Plus Drugs ($6.15/mo cash pay without insurance prior authorization).