Prescribing of diuretic is rising especially in young adults
Key Takeaways Spironolactone use among young women and girls has been growing since 2000 for acne and other androgen-related conditions. Although established for cardiovascular indications, spironolactone is not proven safe for relatively healthy young people using it off-label. The FDA label for spironolactone warns of hyperkalemia, hypotension, worsening renal function, electrolyte and metabolic abnormalities, and gynecomastia. With spironolactone (Aldactone) treatment for acne rising several-fold in recent decades, safety concerns persist for this off-label practice in understudied populations. A database of U.S. insurance claims showed that among girls and women ages 12-40 years, new prescriptions of spironolactone increased from a standardized monthly mean of 17 per 100,000 covered individuals in 2000 to 88 per 100,000 in 2020. Of the 38 million generally healthy young women and girls in the claims database, 1.2% initiated spironolactone. While the rise in spironolactone initiation was observed across age subgroups, women ages 19-25 showed the greatest increase, reported a group led by Sarah Soppe, MPH, of University of North Carolina at Chapel Hill, in JAMA Network Open. "Most initiators had androgen-related conditions, indications frequently requiring higher doses than those examined in clinical trials for cardiovascular disease," Soppe and colleagues noted, adding that…