Brand Reference: Aldactone
| 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 |
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.
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.
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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.
Completed 10 weeks on Spironolactone (50 mg PO daily). Zero notable side effects on steady dosing.
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).