Topical Spironolactone Prescription for Male Pattern Hair Loss
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Before Proceeding to the Topical Spironolactone Medial Consultation Form please read
CONTRAINDICATIONS and WARNINGS
and accept the Waiver of Liability



 In order for Medical Wellness Center Physicians to provide you with the best care you need to reply honesty to all questions and you need to understand any and all risks and side effects associated with Topical Spironolactone for male pattern hair loss.

CONTRAINDICATIONS:

  • Do NOT use Topical Spironolactone if you are allergic to any one of the ingredients: 
        Active ingredient - Spironolactone 
        Inactive Ingredients:  Spironolactone Solution: Propylene glycol, fragrance, ethanol; Spironolactone Lotion: Propylene glycol, fragrance, water, emollient cream; Spironolactone Cream: Propylene glycol, fragrance emollient cream
  • Do NOT use Topical Spironolactone if you have problems with hyperkalemia (high blood potassium).
  • Do NOT use Topical Spironolactone if you have kidney disease or Addison's disease
  • Do NOT use Topical Spironolactone if you are taking oral Spironolactone or Aldactone.
  • Do NOT use Topical Spironolactone  if you are pregnant or nursing
  • Do NOT use Topical Spironolactone for scalp hair loss if you are a genetic female.  Male pattern hair loss and hair loss in women can be due to a serious life-threatening underlying medical condition. 
  • Do NOT use Topical Spironolactone on any area of the scalp if is is sunburned, irritated, red, painful or has a skin disorder such as psoriasis or eczema
  • Do NOT use Topical Spironolactone  if you are under age 18.
    IMPORTANT WARNING:

    If you experience any signs of an allergic reaction including trouble breathing, rapid or weak heartbeat, seizures, redness, swelling, itching or pain, seek immediate medical assistance. 
     
     

    TOPICAL SPIRONOLACTONE  SOLUTION SIDE EFFECTS:

    Unlike oral Spironolactone which can have many serious side effects, side effects for Topical Spironolactone when used as directed were minimal to non-existent.  When applied topically to the scalp as directed, spironolactone appears to have only a localized effect.  Even though the Spironolactone gets absorbed, it is metabolized quickly and essentially does not have any system side effects.  Side effects are rare.  The most common side effects, if any, are localized itching or redness and other skin irritations of the treated area of the scalp.  Spironolactone should ONLY be applied to the scalp.  The risk of side effects increases if applied to other parts of the body.  Always WASH hands after use

    Do not get in eyes - if accidentally gets in eyes flush with water immediately and if irritation persists seek immediate medical attention in an emergency room. 
     
     

    IMPORTANT INFORMATION:


    • Topical Spironolactone is to be applied topically ONLY, do not ingest.
    • Topical Spironolactone is NOT to be used more than once a day.
    • Topical Spironolactone is SAFE when used as directed!
    • Topical Spironolactone is to be used externally only.
    • Topical Spironolactone is not be be put in the eye.
    • Topical Spironolactone formulations do have a slight sulfur-like odor.  Any formulation purporting to be odor-free has altered the molecular structure of the compound.


 

I DO NOT HAVE ANY OF THE ABOVE CONTRAINDICATIONS:
By accepting "I Agree" means that you have read the above contraindication and warnings and honestly acknowledge that you do not have any of the above contraindications to Topical Spironolactone  therapy and understand that insurance will not cover the cost of the medication.  Also, that I am aware that I need to inform my doctor that I am using Topical Spironolactone
Topical Spironolactone I agree  - proceed to waiverTopicalSpironolactione  I disagree

 

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