Two medicines, side by side
Spironolactone vs minoxidil
Spironolactone and minoxidil are both labeled for high blood pressure. Drugs@FDA records approvals of spironolactone since 1960 and of minoxidil since 1979. Pharmacies paid $0.0426 per spironolactone 25 mg tablet and $0.156 per minoxidil 10 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, spironolactone is an aldosterone antagonist and minoxidil an arteriolar vasodilator.
Check it at the source: the spironolactone FDA label on DailyMed (effective November 28, 2025); the minoxidil FDA label on DailyMed (effective September 6, 2024).
Highlights of the spironolactone record
Spironolactone (Aldactone) · label of November 28, 2025
Used for
From the label: indicationsALDACTONE is an aldosterone antagonist indicated for: • The treatment of NYHA Class III–IV heart failure and reduced ejection fraction to increase survival, manage edema, and to reduce the need for hospitalization for heart failure ( 1.1 ). • Use as an add-on therapy for the treatment of hypertension, to lower blood pressure. […]
On the market
- Earliest approval on file
- January 21, 1960
- Generic labelers
- 38 labelers
- Pharmacy cost
- $0.0426 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 6
Highlights of the minoxidil record
Minoxidil (Rogaine) · label of September 6, 2024
Used for
From the label: indicationsto regrow hair on the scalp
On the market
- Earliest approval on file
- October 18, 1979
- Generic labelers
- 86 labelers
- Pharmacy cost
- $0.156 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Source: FDA drug labels via openFDA (Spironolactone label of November 28, 2025, Minoxidil label of September 6, 2024); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do spironolactone and minoxidil differ on the record?
In FDA's classes, spironolactone is an aldosterone antagonist and minoxidil an arteriolar vasodilator.
Only the minoxidil label carries a boxed warning.
Generics: spironolactone since 1980; minoxidil since 1987 (Drugs@FDA).
| Spironolactone | Minoxidil | |
|---|---|---|
| Labeled for | Heart failure, Edema (fluid retention), High blood pressure | High blood pressure |
| Pharmacologic class | Aldosterone Antagonist | Arteriolar Vasodilator |
| How it works (label) | Spironolactone and its active metabolites are specific pharmacologic antagonists of aldosterone, acting primarily through competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted … | n/a |
| Half-life (label) | The mean half-life values of its metabolites including canrenone, 7-α-(thiomethyl) spirolactone (TMS), and 6-β-hydroxy-7-α-(thiomethyl) spirolactone (HTMS) are 16.5, 13.8, and 15 hours, respectively. | n/a |
| Earliest approval on file (Drugs@FDA) | January 21, 1960 | October 18, 1979 |
| First generic approved | May 7, 1980 | March 3, 1987 |
| Generic labelers (NDC) | 38 labelers | 86 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0426 per tablet (Spironolactone 25 mg tablet) | $0.156 per tablet (Minoxidil 10 mg tablet) |
| 12-month price change | -14% | -17% |
| Boxed warning | No | Yes |
| Shortage now | A presentation being discontinued | No current entry |
| Recalls recorded | 6 | 1 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 139,757 | 44,687 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to spironolactone
- every medicine labeled for the same conditions