From the Guidelines
Both spironolactone and birth control pills can potentially cause drowsiness in some individuals, though it's not among the most common side effects for either medication. Spironolactone, a diuretic often used to treat conditions like high blood pressure, heart failure, and hormonal acne, may cause drowsiness in some patients, particularly when first starting the medication or after dose increases, as noted in a study published in the Journal of the American Academy of Dermatology 1. This drowsiness occurs because spironolactone affects electrolyte balance and can lower blood pressure, which might temporarily affect alertness. Some key points to consider about spironolactone include:
- Common side effects include menstrual irregularities, diuresis, breast tenderness, breast enlargement, gynecomastia, fatigue, headache, and dizziness 1
- Potassium monitoring should be considered in older patients or those with medical co-morbidities 1
- Spironolactone should not be used in pregnancy due to potential risks to the fetus 1 Birth control pills containing hormones like estrogen and progestin can also cause fatigue or drowsiness in some women, especially during the first few months of use as the body adjusts to the hormonal changes, as discussed in a study published in the Journal of the American Academy of Dermatology 1. The severity of drowsiness varies significantly between individuals for both medications. Some key points to consider about birth control pills include:
- Common side effects include breakthrough bleeding, nausea, and breast tenderness 1
- More serious adverse effects associated with birth control pills include thromboembolic events, although the risk is low in otherwise healthy women 1
- Birth control pills have been associated with a reduced risk of certain cancers, including colon, uterine, and ovarian cancer 1 If experiencing troublesome drowsiness, taking the medication before bedtime might help minimize daytime symptoms. It's essential to discuss persistent drowsiness with your healthcare provider, as dosage adjustments or alternative medications might be appropriate if drowsiness interferes with daily activities.
From the FDA Drug Label
The oral LD 50 of spironolactone is greater than 1,000 mg/kg in mice, rats, and rabbits. Acute overdosage of spironolactone may be manifested by drowsiness, mental confusion, maculopapular or erythematous rash, nausea, vomiting, dizziness, or diarrhea. Nervous system/psychiatric: Lethargy, mental confusion, ataxia, dizziness, headache, drowsiness.
Drowsiness is a potential effect of spironolactone, as seen in cases of acute overdosage and as a reported adverse reaction in clinical trials or postmarketing reports 2 2. There is no information about birth control pills in the provided drug labels. Key points:
- Spironolactone may cause drowsiness.
- No information is available about birth control pills.
From the Research
Spironolactone and Drowsiness
- There is no direct evidence in the provided studies that spironolactone causes drowsiness 3, 4, 5, 6.
- The studies primarily focus on the effects of spironolactone on hirsutism, hyperandrogenism, and its interaction with estrogen and androgen receptors 3, 4, 5.
- One study examines the cognitive impacts of drospirenone, a spironolactone-derived progestin, and finds that it can have beneficial effects on spatial memory in ovariectomized rats, but these effects are reversed when combined with ethinyl estradiol 7.
Birth Control Pills and Drowsiness
- The provided studies do not directly investigate the effects of birth control pills on drowsiness 3, 4, 5, 6, 7.
- One study mentions the use of norethindrone and ethinyl estradiol in combination with spironolactone for the treatment of hirsutism, but does not report any effects on drowsiness 3.
- Another study examines the cognitive impacts of ethinyl estradiol when combined with drospirenone, a spironolactone-derived progestin, and finds that it can reverse the beneficial effects of drospirenone on spatial memory 7.