Public record

Spironolactone: the public record

10 tables from US federal sources. Latest data date: Nov 11, 2026.

Each table is computed from the named federal dataset as of its data date; the method is under each one.

Label

FDA label facts for spironolactone

The FDA label read for spironolactone (Aldactone, application NDA012151) was last revised on 2025-11-28. It carries no boxed warning. Of the 4 population sections checked, 4 are present: pregnancy, lactation, pediatric use, geriatric use.

FDA label facts for spironolactone: the figures
MeasureValueNote
Label revision date2025-11-28
Label readAldactoneNDA012151, brand-name application
Boxed warningNo
Pregnancy sectionPresent
Lactation sectionPresent
Pediatric use sectionPresent
Geriatric use sectionPresent

Source: FDA drug label via openFDA, viewable on NIH DailyMed, data as of Nov 11, 2026

How this was calculated

Selected the most recently revised prescription label for this single ingredient from an original manufacturer, preferring a brand-name application. Checked which sections exist and quoted headings and sentences exactly as printed.

Scope: One label: the newest prescription label for single-ingredient spironolactone from an original manufacturer

Read from one label. Labels for other brands, strengths or forms of the same ingredient can differ. A missing section heading does not mean there is no guidance. Read the full label before relying on it.

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Approvals

FDA approval history for spironolactone

The earliest FDA approval on file for a spironolactone product is 1960-01-21. Drugs@FDA lists 29 applications for it and 213 approved supplements, the most recent on 2026-09-23.

FDA approval history for spironolactone: the figures
MeasureValueNote
Earliest FDA approval on file1960-01-21
Applications with an approval on file29
New drug applications (NDA)2
Generic applications (ANDA)27
Approved supplements213label, manufacturing and efficacy changes
Most recent supplement approval2026-09-23
Sponsoring companies27

Source: FDA, Drugs@FDA, data as of Nov 11, 2026

How this was calculated

Selected applications with a product whose only active ingredient is this substance, then counted approved original and supplemental submissions. The earliest approved original submission is the first approval.

Scope: Applications with a single-ingredient spironolactone product in Drugs@FDA, all sponsors and strengths

Older approvals can be missing dates, and tentative approvals are not counted. An approved application does not mean the product is currently marketed.

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Patents and generics

Patents and generic approvals for spironolactone

The FDA Orange Book lists 27 approved generic applications for spironolactone, the first approved on 1982-02-01. 8 listed patents on specific brand products have not yet expired, the last on 2036-10-28; generics of other versions are already approved.

Patents and generic approvals for spironolactone: the figures
MeasureValueNote
Brand-name applications (NDA)2
Approved generic applications (ANDA)27first approved 1982-02-01
Companies with a generic not marked discontinued12
Listed patents not yet expired8
Latest listed patent expiry2036-10-28on any product; may cover only one brand formulation
Earliest approval date on filebefore 1982
Products not marked discontinued36 of 53

Source: FDA, Orange Book (Approved Drug Products with Therapeutic Equivalence Evaluations), data as of Oct 9, 2026

How this was calculated

Selected Orange Book products whose only active ingredient is this substance, then counted applications by type and the distinct patents and exclusivities listed against them. Expired patents are left out.

Scope: All single-ingredient spironolactone products in the Orange Book, every brand and strength, files dated 2026-10-09

An approved generic or an expired patent does not show that a generic is on sale. Launch timing also depends on litigation, settlements and supply. Biologics and compounded products are not in the Orange Book.

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Medicare Part D

Medicare Part D claims for spironolactone by age group

Of 9,080,082 Medicare Part D claims for spironolactone in 2024, 7,902,086 (87.0%) were for enrollees aged 65 and over and 1,177,996 were for enrollees under 65.

Medicare Part D claims for spironolactone by age group: the figures
MeasureValueNote
All Part D claims, 20249,080,082
Claims for enrollees aged 65 and over7,902,086
Claims for enrollees under 651,177,996mostly people who qualify through disability
Share of claims for enrollees aged 65 and over87.0%share of claims, not of patients

Source: CMS, Medicare Part D Prescribers by Geography and Drug, data as of 2024

How this was calculated

Summed the national rows for every brand and generic row with this generic name. Claims under 65 are total claims minus claims for enrollees 65 and over.

Scope: National Part D claims for single-ingredient spironolactone products, 2024, split at age 65

Medicare mostly covers people 65 and over, so this split describes Medicare enrollees and not use in the general population.

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Medicare Part D

Medicare Part D spending on spironolactone

Medicare Part D spending on spironolactone products was $81.2M in 2024 across 9,082,905 claims, compared with $102.9M in 2023 (-21.0%). Average spending per claim was $8.94, before rebates.

Medicare Part D spending on spironolactone: the figures
MeasureValueNote
Total spending, 2024$81.2M
Total spending, 2023$102.9M
Change in spending, 2023 to 2024-21.0%
Claims (prescription fills), 20249,082,905
Average spending per claim, 2024$8.94
Spironolactone: spending, 2024$80.6M9,081,323 claims
Aldactone: spending, 2024$428,5871,291 claims
Carospir: spending, 2024$186,000291 claims

Source: CMS, Medicare Part D Spending by Drug, data as of 2024

How this was calculated

Summed total spending and claims over every brand and generic row with this generic name in the CMS file, using the Overall manufacturer rows. Combination products excluded. Average per claim is spending divided by claims.

Scope: Every single-ingredient spironolactone product in Part D (Spironolactone, Aldactone, Carospir), 2024.

Gross drug cost before manufacturer rebates, so net cost is lower. Part D excludes some uses by law (for example erectile dysfunction, weight loss and hair growth), so claims reflect covered uses only. Compounded products are not included.

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Medicaid

Medicaid prescriptions for spironolactone by state

State Medicaid programmes paid for 2,573,178 spironolactone prescriptions in 2025, with $36.4M reimbursed before rebates. California reported the most (294,514), followed by New York (199,764) and Ohio (140,760); 52 states and territories reported any.

Medicaid prescriptions for spironolactone by state: the figures
MeasureValueNote
Prescriptions paid by Medicaid, 20252,573,178
Total reimbursed before rebates, 2025$36.4M
States and territories reporting52with at least one count CMS did not suppress
California294,514 prescriptions$5.7M reimbursed
New York199,764 prescriptions$3.3M reimbursed
Ohio140,760 prescriptions$1.9M reimbursed
Pennsylvania139,862 prescriptions$1.8M reimbursed
Michigan108,948 prescriptions$773,096 reimbursed

Source: CMS, Medicaid State Drug Utilization Data 2025, data as of 2025

How this was calculated

Matched each Medicaid product code to the FDA NDC Directory by labeler and product code, kept finished single-ingredient products, then summed prescriptions and reimbursement by state. National roll-up and suppressed rows dropped.

Scope: All single-ingredient spironolactone products in the FDA NDC Directory, fee-for-service and managed care, 2025

Counts under 11 are suppressed by CMS and left out, so totals are a floor. Amounts are before rebates. Differences between states reflect programme size and coverage rules. Compounded products are not included.

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Pharmacy cost

Pharmacy acquisition cost (NADAC) for spironolactone

Retail pharmacies paid an average of $0.0426 per unit for SPIRONOLACTONE 25 MG TABLET as of 2026-11-11, compared with $0.0503 twelve months earlier (-15.3%). This is a pharmacy purchase cost, not a patient price.

Pharmacy acquisition cost (NADAC) for spironolactone: the figures
MeasureValueNote
SPIRONOLACTONE 25 MG TABLET$0.0426 per unit12 months earlier $0.0503 (-15.3%)
SPIRONOLACTONE 50 MG TABLET$0.0833 per unit12 months earlier $0.0972 (-14.3%)
SPIRONOLACTONE 100 MG TABLET$0.1640 per unit12 months earlier $0.1887 (-13.1%)
SPIRONOLACTONE 25 MG/5 ML SUSP$1.81 per mL12 months earlier $2.03 (-10.7%)

Source: CMS, National Average Drug Acquisition Cost (NADAC), data as of Nov 11, 2026

How this was calculated

Matched NADAC product codes to the FDA NDC Directory, kept finished single-ingredient products, and listed the product descriptions with the most package codes. The earlier price is the same package code in the file one year before.

Scope: Generic versions of spironolactone in the weekly NADAC file of 2026-11-11, compared with the file of 2025-11-12

NADAC is the average invoice price retail pharmacies pay, from a voluntary survey. It leaves out rebates, dispensing fees and markups, and it is not what a patient or insurer pays. Compounded products are not surveyed.

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Adverse event reports

Most reported events in FDA adverse event reports for spironolactone

Through 2026-10-28, FDA had received 123,138 adverse event reports for spironolactone, 95,032 of them marked serious by the reporter. The symptom terms named most often were dyspnoea (9,633), fatigue (7,899) and acute kidney injury (7,549).

Most reported events in FDA adverse event reports for spironolactone: the figures
MeasureValueNote
All reports received123,138
Reports the reporter marked serious95,032death, hospitalisation, disability or similar outcome
Dyspnoea9,633 reports
Fatigue7,899 reports
Acute kidney injury7,549 reports
Nausea7,101 reports
Diarrhoea7,073 reports

Source: FDA Adverse Event Reporting System (FAERS) via openFDA, data as of Oct 28, 2026

How this was calculated

Counted FAERS reports listing this active substance, then the reaction terms named most often. A report can name several reactions, and a term can describe the illness being treated and not an effect of the drug.

Scope: Reports where FDA recorded spironolactone as a single-ingredient active substance (any brand), all years to 2026-10-28

FAERS reports are unverified and do not prove the drug caused the event. Reporting rises with use, publicity and lawsuits, so these counts cannot give rates or risks and cannot be compared between drugs.

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Recalls

FDA drug recalls naming spironolactone

FDA enforcement reports list 11 drug recall entries naming spironolactone from 2013 to 2025-08-13. 9 of them are for compounded or other unlisted products and 2 for products FDA lists under a label. The most common stated reason was dissolution or stability failure (3 of 11).

FDA drug recalls naming spironolactone: the figures
MeasureValueNote
Recall entries on record11
For products FDA lists under an approved or registered label2
For compounded or other unlisted products9matched by the name in the product description
Class I (most serious)2
Class II9
Class III0
Most recent recall reported2025-08-13
Most common stated reasondissolution or stability failure3 of 11 entries

Source: FDA, Enforcement Reports (drug recalls) via openFDA, data as of Nov 10, 2026

How this was calculated

Counted enforcement report entries matched by FDA's listed active substance, or by the name in the product description where FDA lists none. Reasons were grouped by keywords in FDA's stated reason.

Scope: Recalls of single-ingredient spironolactone products, plus compounded or unlisted products whose description names it

Each recall covers specific lots from one firm and is not a statement about every product with this ingredient. One event can appear as several entries, one per product.

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Clinical studies

Registered clinical studies of spironolactone

ClinicalTrials.gov lists 331 registered studies that name spironolactone as an intervention as of 2026-11-11. Of these, 33 are recruiting, 164 are completed and 54 are phase 3 studies.

Registered clinical studies of spironolactone: the figures
MeasureValue
Registered studies331
Recruiting now33
Not yet recruiting16
Completed164
Terminated, withdrawn or suspended43
Phase 3 (including phase 2/3)54
Phase 2 (including phase 1/2)61
Phase 124

Source: NIH National Library of Medicine, ClinicalTrials.gov, data as of Nov 11, 2026

How this was calculated

Searched the ClinicalTrials.gov intervention field for the name, downloaded every matching record and counted by overall status and phase. Combined phases are counted under the higher phase. Phase not applicable covers observational, device and behavioural studies.

Scope: Studies whose intervention field matches spironolactone, any condition, any country, all statuses

A registered study is not a result. Counts include studies where the drug is a comparator or background treatment, and studies that never finished or reported.

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