What it's used for
Spironolactone is used to treat NYHA Class III-IV heart failure to increase survival, manage fluid buildup, and reduce hospitalizations. It is also used as an add-on therapy to lower blood pressure in the treatment of hypertension.
Source: U.S. FDA-approved prescribing information (openFDA).
Typical dosing
Treatment for heart failure is initiated at 25 mg once daily, while hypertension treatment is initiated at 25 to 100 mg daily in single or divided doses.
Dosing shown here is the general FDA-labeled range. Your prescribing clinician determines the exact dose, form, and schedule for you — this is not a substitute for medical advice.
Common side effects
Common adverse reactions include high potassium levels, low blood pressure, worsening kidney function, electrolyte abnormalities, and breast enlargement in males.
Covered strengths on the Tab $0 list
Covered at $0 with an active Tab membership when filled at a participating pharmacy nationwide or through mail order. A licensed clinician must prescribe the medication.
Related medications
Other heart, blood pressure & cholesterol medications covered at $0 with an active Tab membership.
Spironolactone cost without insurance
Cash prices for Spironolactone without insurance vary widely by pharmacy, strength and quantity — the same prescription can cost very different amounts at two pharmacies in the same town. That is the problem a membership solves.
Spironolactone is on Tab's covered $0 generic list. With an active Tab membership, every covered strength is $0 — not a percentage off, not a coupon that changes month to month — at participating pharmacies nationwide or through mail order. You do not need insurance, and Tab works whether or not you have a health plan.
Tab is a membership, not insurance. Covered medications require a prescription from a licensed clinician.
Spironolactone dosage and administration
Heart Failure: Initiate treatment at 25 mg once daily ( 2.2 ). Hypertension: Initiate treatment at 25 to 100 mg daily in either single or divided doses ( 2.3 ). Edema: Initiate therapy in a hospital setting and titrate slowly. The recommended initial daily dose is 100 mg in single or divided doses ( 2.4 ). Primary hyperaldosteronism: Initiate treatment at 100 to 400 mg in preparation for surgery. In patients unsuitable for surgery use the lowest effective dosage determined for the individual patient ( 2.5 ). 2.1 General Considerations Spironolactone can be taken with or without food, but should be taken consistently with respect to food [see Clinical Pharmacology (12.3) ] . 2.2 Treatment of Heart Failure In patients with serum potassium ≤5.0 mEq/L and eGFR >50 mL/min/1.73 m², initiate treatment at 25 mg once daily.
Excerpt from the FDA-approved prescribing information (openFDA), retrieved 2026-09-15. Your prescribing clinician decides the exact dose, form and schedule for you — this is not medical advice.
Spironolactone side effects
The following clinically significant adverse reactions are described elsewhere in the labeling: Hyperkalemia [see Warnings and Precautions (5.1) ] Hypotension and Worsening Renal Function [see Warnings and Precautions (5.2) ] Electrolyte and Metabolic Abnormalities [see Warnings and Precautions (5.3) ] Gynecomastia [see Warnings and Precautions (5.4) ] Impaired neurological function/ coma in patients with hepatic impairment, cirrhosis and ascites [see Use in Specific Populations (8.7) ] The following adverse reactions associated with the use of spironolactone were identified in clinical trials or postmarketing reports. Because these reactions were reported voluntarily from a population of uncertain size, it is not always possible to estimate their frequency, reliably, or to establish a causal relationship to drug exposure.
Excerpt from the FDA-approved prescribing information (openFDA), retrieved 2026-09-15. This is not a complete list. Report side effects to your clinician, and seek care for anything severe or unexpected.
Spironolactone drug interactions
Agents increasing serum potassium: Concomitant administration can lead to hyperkalemia ( 5.1 , 7.1 ). Lithium: Increased risk of lithium toxicity ( 7.2 ). NSAIDs: May reduce the diuretic, natriuretic and antihypertensive effect of spironolactone ( 7.3 ). Digoxin: spironolactone can interfere with radioimmunologic assays of digoxin exposure ( 7.4) . Cholestyramine: Hyperkalemic metabolic acidosis has been reported with concomitant use ( 7.5 ). Acetylsalicylic Acid (ASA): ASA may reduce the efficacy of spironolactone ( 7.6 ) Abiraterone: May increase prostate-specific antigen (PSA) levels ( 7.7 ). 7.1 Drugs and Supplements Increasing Serum Potassium Concomitant administration of spironolactone with potassium supplementation or drugs that can increase potassium may lead to severe hyperkalemia.
Excerpt from the FDA-approved prescribing information (openFDA), retrieved 2026-09-15. Tell your clinician and pharmacist about every medication, supplement and over-the-counter product you take.
Who should not take spironolactone
Spironolactone is contraindicated in the patients with: Hyperkalemia Addison’s disease Concomitant use of eplerenone Spironolactone is contraindicated in patients with ( 4 ): Hyperkalemia Addison’s disease Concomitant use of eplerenone
Excerpt from the FDA-approved prescribing information (openFDA), retrieved 2026-09-15. Whether this medication is appropriate for you is a clinical decision made by your prescribing clinician.
Common questions
Is spironolactone covered at $0 with Tab?
Yes. Spironolactone is on Tab's covered $0 generic list — every covered strength is $0 with an active membership, at participating pharmacies nationwide or by mail order.
Do I need insurance to get spironolactone through Tab?
No. Tab is a membership, not insurance. Covered medications are $0 with an active membership whether or not you have a health plan.
How do I get a spironolactone prescription with Tab?
Book a video visit with a licensed Tab clinician (unlimited visits are included with membership). If it's clinically appropriate, they send the prescription to your chosen participating pharmacy or by mail order.
How much does spironolactone cost without insurance?
Without insurance, retail cash prices for spironolactone vary by pharmacy, strength and quantity. Spironolactone is on Tab's covered $0 generic list, so every covered strength is $0 with an active Tab membership at participating pharmacies nationwide or by mail order.
What is the cheapest way to get spironolactone?
For medications on Tab's covered list, a Tab membership is the cheapest route: covered strengths of spironolactone are $0 with an active membership, and unlimited video visits with a licensed clinician are included, so the visit that produces the prescription is covered too.
What is the usual dose of spironolactone?
Heart Failure: Initiate treatment at 25 mg once daily ( 2.2 ). Hypertension: Initiate treatment at 25 to 100 mg daily in either single or divided doses ( 2.3 ). Edema: Initiate therapy in a hospital setting and titrate slowly. The recommended initial daily dose is 100 mg in single or divided doses ( 2.4 ). Primary hyperaldosteronism: Initiate treatment at 100 to 400 mg in preparation for surgery. (FDA-approved label, retrieved 2026-09-15. Your clinician sets your dose.)
What are the side effects of spironolactone?
The following clinically significant adverse reactions are described elsewhere in the labeling: Hyperkalemia [see Warnings and Precautions (5.1) ] Hypotension and Worsening Renal Function [see Warnings and Precautions (5.2) ] Electrolyte and Metabolic Abnormalities [see Warnings and Precautions (5.3) ] Gynecomastia [see Warnings and Precautions (5.4) ] Impaired neurological function/ coma in patients with hepatic impairment, cirrhosis and ascites [see Use in Specific Populations (8.7) ] The following adverse reactions associated with the use of spironolactone were identified in clinical trials or postmarketing reports. (FDA-approved label, retrieved 2026-09-15.)
What interacts with spironolactone?
Agents increasing serum potassium: Concomitant administration can lead to hyperkalemia ( 5.1 , 7.1 ). Lithium: Increased risk of lithium toxicity ( 7.2 ). NSAIDs: May reduce the diuretic, natriuretic and antihypertensive effect of spironolactone ( 7.3 ). Digoxin: spironolactone can interfere with radioimmunologic assays of digoxin exposure ( 7.4) . (FDA-approved label, retrieved 2026-09-15. Tell your clinician about every medication and supplement you take.)
Spironolactone is $0 on the covered list
Members pay $0 for covered generics at participating pharmacies nationwide or by mail order — plus unlimited virtual primary care, urgent care and dermatology visits. No insurance needed.
Solo $49/mo · Family $119/mo for up to 4 people · Family+ $149/mo for up to 8
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