Spironolactone + Minoxidil
Two hair-loss medicines, one daily capsule. Spironolactone blocks the hormones that thin hair along the part, and low-dose minoxidil helps follicles grow. Both are prescribed off-label for female pattern hair loss, and here they’re compounded together in one capsule, in the strengths your provider sets. Give it 3 to 6 months.
- Two medicines in one daily capsule
- Strengths set by your provider
- For female pattern hair loss (off-label)
Daily capsule · from $59/mo. Prices are preliminary.
How to use it
- Take one capsule a day, at about the same time.
- Use reliable birth control while you take it. Stop and tell your provider right away if you become pregnant.
- Get help right away for a resting pulse 20 or more beats a minute above your normal, a quick weight gain or new swelling, shortness of breath, chest pain or fainting.
- Form
- Capsule, 30 per bottle
- Strength
- Spironolactone and minoxidil, in strengths your provider sets
- Typical use
- One capsule a day, at about the same time
- Who it’s for
- Women with female pattern hair loss who aren’t pregnant, trying to get pregnant or breastfeeding, if a provider decides it’s right for them
Two actives, one capsule.
- Spironolactone (Strength set by your provider): Blocks androgens, the hormones that shrink hair follicles along the part. At higher doses it’s a blood pressure and fluid medicine.
- Minoxidil (Low dose, set by your provider): Widens small blood vessels and lengthens the hair’s growing phase. The doses used for hair are a small fraction of the blood pressure dose.
What the research does and doesn’t show
Together: in a study of 100 women taking one daily capsule with very low doses of both, minoxidil 0.25 mg and spironolactone 25 mg, shedding and thinning scores improved over 12 months. That study had no comparison group.
Minoxidil by mouth: in a small trial, women taking 1 mg a day gained about as much hair density as women using 5% minoxidil on the scalp. In a records study of 1,404 people on low doses, side effects were mostly mild and few stopped because of them.
Spironolactone: in an open study of 80 women, about 4 in 10 saw regrowth and most of the rest stopped losing more; reviews say better trials are needed.
So both are reasonable off-label options with modest, mostly uncontrolled evidence, and the doses studied may differ from yours. Results take 3 to 6 months, and hair loss usually returns if you stop.
Studies: Sinclair, Int J Dermatol 2018 (100 women, minoxidil 0.25 mg + spironolactone 25 mg once daily, 12 months, open-label, uncontrolled; PMID 29231239); Ramos et al., J Am Acad Dermatol 2020 (52 women, oral minoxidil 1 mg vs topical 5%, 24 weeks; PMID 31473295); Vañó-Galván et al., J Am Acad Dermatol 2021 (1,404 patients on low-dose oral minoxidil; PMID 33639244); Sinclair et al., Br J Dermatol 2005 (80 women, spironolactone 200 mg or cyproterone; PMID 15787815); Sobral et al. 2025 meta-analysis of oral vs topical minoxidil (PMID 39425514); spironolactone (Aldactone) and minoxidil tablets prescribing information (DailyMed).
What to expect
- Months 1–2
- Some shedding can happen as hair cycles reset, and it usually settles. Your provider checks in and may check your potassium.
- Months 3–6
- Less shedding and new growth usually start to show. Extra fine hair on the face or body is the most common side effect.
- Ongoing
- Keep taking it to keep the results: hair loss usually returns if you stop. Refills ship on schedule.
Important safety information
Before you start
Your provider reviews your health history, medicines and allergies before prescribing, and prescribes only if it’s right for you. Tell your care team about any side effect, and get emergency care for chest pain, trouble breathing, or swelling of the face, lips or throat.
Side effects, and when to get help
The most common is extra fine hair on the face or body (about 1 in 7 in a large study of low-dose minoxidil). Others include light-headedness, ankle or face swelling, a faster heartbeat, headache, irregular periods and breast tenderness. Get help right away for a resting pulse 20 or more beats a minute above your normal, a weight gain of 5 pounds or more within a few days or new swelling of your face, hands, ankles or belly, shortness of breath (especially lying down), chest, arm or shoulder pain, fainting, muscle weakness or an irregular heartbeat, or a blistering or peeling rash.
Rules that keep it safe
Don’t take it if you’re pregnant, trying to get pregnant or breastfeeding, and use reliable birth control while you do. Don’t take it with high potassium, Addison’s disease, kidney disease, heart failure or another serious heart condition, fluid around the heart, low blood pressure or a pheochromocytoma, or with eplerenone. Tell your clinician about blood pressure medicines, potassium supplements or salt substitutes, lithium, trimethoprim, daily anti-inflammatories and a drospirenone birth control pill; they may check your potassium.
Is it FDA-approved?
No. This capsule is compounded: prepared by a licensed pharmacy for you, and not reviewed by the FDA for safety, effectiveness or quality. Spironolactone and minoxidil tablets are FDA-approved for heart and blood pressure conditions, not for hair loss, so using them for hair loss is off-label. Minoxidil tablets carry a boxed warning about serious heart effects at blood pressure doses, which are many times the doses used for hair.
About Spironolactone + Minoxidil
How is this different from Minoxidil + Dutasteride?
That capsule is for men. Dutasteride isn’t used by women who could become pregnant, so this capsule pairs low-dose minoxidil with spironolactone, which blocks the same hair-thinning hormones in a different way.
Will I grow facial hair?
It’s the most common side effect: in a large study of low-dose minoxidil, about 1 in 7 people noticed extra fine hair on the face or body. It’s usually mild, and your provider can lower the dose.
How long until I see results?
Give it 3 to 6 months, and up to a year for the full effect. Some shedding in the first weeks can happen as hair cycles reset.
Do I need blood tests?
Your provider may check your potassium, especially if you have kidney problems or take medicines that raise it. In healthy young women on spironolactone, high potassium is rare.
Can I take it if I could get pregnant?
Yes, with reliable birth control. It isn’t used during pregnancy or while breastfeeding, so stop and tell your provider right away if you become pregnant.