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Last Updated: April 3, 2026

CLINICAL TRIALS PROFILE FOR SPIRONOLACTONE


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All Clinical Trials for SPIRONOLACTONE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00001202 ↗ Treatment of Boys With Precocious Puberty Completed Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Phase 2 1985-01-01 This study is a continuation of two previous studies conducted at the NIH. The first study , "Treatment of True Precocious Puberty with a Long-Acting Lutenizing Hormone Releasing Hormone Analog (D-Trp(6)-Pro(9)-Net-LHRH)" had less than optimal results. Some patients, all of whom were diagnosed with familial isosexual precocious puberty, had an inadequate response to the medication and were observed to have high levels of testosterone, advanced bone aging, and other complications of the disease. As a result these patients were enrolled in a second study In the second study, "Spironolactone Treatment for Boys with Familial Isosexual Precocious Puberty", - the patients received another medication, spironolactone (Aldactone). The drug blocked the effects of testosterone, -but bone age advancement did not improve. Some patients began experiencing gynecomastia (an abnormal growth of the male breasts). Researchers believe these may be the effects of elevated levels of estrodiol (a form of the female hormone, estrogen). In the present study, testolactone is added to the drug regimen to block the production of estrogen. The study therefore uses spironolactone to prevent the action of the male hormones (androgen) and testolactone to block the production of female hormones (estrogen). Deslorelin, an LHRH analog which works by turning off true (central) puberty, is added to the drug regimen once true puberty begins. This is because it is know that boys with familial male precocious puberty go into true puberty too early (despite treatment with spironolactone and testolactone), and when that happens, the spironolactone and testolactone are no longer as effective. The goal of the treatment is to delay sexual development until a more appropriate age and prevent short adult stature (height).
NCT00004311 ↗ Phase II Study of the Effect of Leuprolide Acetate and Spironolactone on Insulin Resistance in Hyperandrogenic Women With Polycystic Ovarian Disease or Hyperandrogenism Insulin Resistance Acanthosis Nigricans Syndrome Completed Baylor College of Medicine Phase 2 1989-07-01 OBJECTIVES: I. Evaluate insulin resistance in thin and obese hyperandrogenic women with polycystic ovarian disease or hyperandrogenism insulin resistance acanthosis nigricans syndrome and in thin and obese controls, using an estimation of tissue sensitivity to insulin. II. Evaluate the effect of androgen suppression with leuprolide acetate and spironolactone on insulin secretion and resistance.
NCT00004311 ↗ Phase II Study of the Effect of Leuprolide Acetate and Spironolactone on Insulin Resistance in Hyperandrogenic Women With Polycystic Ovarian Disease or Hyperandrogenism Insulin Resistance Acanthosis Nigricans Syndrome Completed National Center for Research Resources (NCRR) Phase 2 1989-07-01 OBJECTIVES: I. Evaluate insulin resistance in thin and obese hyperandrogenic women with polycystic ovarian disease or hyperandrogenism insulin resistance acanthosis nigricans syndrome and in thin and obese controls, using an estimation of tissue sensitivity to insulin. II. Evaluate the effect of androgen suppression with leuprolide acetate and spironolactone on insulin secretion and resistance.
NCT00007592 ↗ Hypertension Screening and Treatment Program Completed US Department of Veterans Affairs 1989-06-01 Hypertension is one of the most common medical problems in the United States and in the VA health care system. It has been well-documented that hypertension can be effectively treated. However, there remain important unresolved clinical questions in the area of antihypertensive treatment. For example, how much is mortality affected by visit compliance, blood pressure control and type of antihypertensive agent? Or, are some regimens associated with more morbidity than others? Or, are there inexpensive regimens that are as effective as more expensive regimens? The amount of data that is available from this demonstration project (currently 6,100 patients) will help address these questions. The answers to these questions should result in better care for veterans with hypertension.
NCT00007592 ↗ Hypertension Screening and Treatment Program Completed VA Office of Research and Development 1989-06-01 Hypertension is one of the most common medical problems in the United States and in the VA health care system. It has been well-documented that hypertension can be effectively treated. However, there remain important unresolved clinical questions in the area of antihypertensive treatment. For example, how much is mortality affected by visit compliance, blood pressure control and type of antihypertensive agent? Or, are some regimens associated with more morbidity than others? Or, are there inexpensive regimens that are as effective as more expensive regimens? The amount of data that is available from this demonstration project (currently 6,100 patients) will help address these questions. The answers to these questions should result in better care for veterans with hypertension.
NCT00046553 ↗ Brain Receptor Function in Post-Traumatic Stress Disorder Completed National Institute of Mental Health (NIMH) 2002-09-01 The purpose of this study is to examine the function of cortisol receptors in post-traumatic stress disorder (PTSD). Patients with PTSD have neurobiological dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis function. High corticotrophin releasing hormone (CRH) levels and decreased hippocampal volume are major features of the disorder. The mechanisms responsible for these alterations are not known. This study will evaluate the function of cortisol receptors to determine their roles in maintaining PTSD HPA axis dysregulation. Three groups of subjects will take part in the study: Patients with PTSD, healthy control subjects who were exposed to trauma in the past and remained healthy and healthy control subjects who were never traumatized At study entry, the cerebral spinal fluid (CSF) of all participants will be sampled and evaluated. Participants will also undergo a magnetic resonance imaging (MRI) scan of the brain as well as eye blink trace conditioning and neuropsychological tests. Participants will be admitted to the Clinical Center for two nights on three different occasions. At each overnight visits, blood levels of stress hormones will be measured every hour for 26 hours after medication or placebo are given. This will be the end of the study for both groups of healthy control subjects, with the exception that they may be asked to repeat neuropsychologic and eye blink tests after 12 weeks. Participants with PTSD will receive paroxetine for 10 weeks. After 10 weeks these participants will be reevaluated in exactly the same way as before treatment (except they will not repeat the MRI scan).
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for SPIRONOLACTONE

Condition Name

Condition Name for SPIRONOLACTONE
Intervention Trials
Hypertension 31
Heart Failure 27
Polycystic Ovary Syndrome 10
Primary Aldosteronism 10
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Condition MeSH

Condition MeSH for SPIRONOLACTONE
Intervention Trials
Heart Failure 56
Hypertension 52
Kidney Diseases 24
Renal Insufficiency, Chronic 19
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Clinical Trial Locations for SPIRONOLACTONE

Trials by Country

Trials by Country for SPIRONOLACTONE
Location Trials
United States 266
Canada 28
Germany 25
United Kingdom 22
Italy 20
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Trials by US State

Trials by US State for SPIRONOLACTONE
Location Trials
Texas 18
Massachusetts 15
Pennsylvania 15
California 14
New York 13
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Clinical Trial Progress for SPIRONOLACTONE

Clinical Trial Phase

Clinical Trial Phase for SPIRONOLACTONE
Clinical Trial Phase Trials
PHASE4 9
PHASE3 5
PHASE2 7
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Clinical Trial Status

Clinical Trial Status for SPIRONOLACTONE
Clinical Trial Phase Trials
Completed 135
Recruiting 51
Unknown status 33
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Clinical Trial Sponsors for SPIRONOLACTONE

Sponsor Name

Sponsor Name for SPIRONOLACTONE
Sponsor Trials
National Heart, Lung, and Blood Institute (NHLBI) 14
Brigham and Women's Hospital 10
Vanderbilt University 8
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Sponsor Type

Sponsor Type for SPIRONOLACTONE
Sponsor Trials
Other 430
Industry 48
NIH 33
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Spironolactone: Clinical Trials Update, Market Analysis, and Future Projections

Last updated: February 20, 2026

What is the current status of clinical trials involving spironolactone?

Spironolactone, a potassium-sparing diuretic and anti-androgen agent, is primarily approved for heart failure, hypertension, and hyperaldosteronism. Ongoing clinical trials focus on expanding its indications, including dermatological conditions, heart failure with preserved ejection fraction (HFpEF), and certain cancers.

Active and Recent Trials (2022–2023)

Trial ID Title Phase Indication Status Expected Completion
NCT04522772 Spironolactone for PCOS Phase 4 Polycystic ovary syndrome Ongoing December 2023
NCT04272777 Spironolactone in HFpEF Phase 3 Heart failure with preserved ejection fraction Recruiting June 2024
NCT03739023 Spironolactone in Breast Cancer Phase 2 Hormone receptor-positive breast cancer Recruiting November 2023

Key Points

  • Trials exploring dermatological uses (e.g., acne, hirsutism) continue to expand.
  • Investigation into HFpEF aims to address a significant unmet need.
  • Cancer-related studies focus on spironolactone's role in tumor growth inhibition via mineralocorticoid receptor pathways.

How has the market for spironolactone evolved?

Historical Market Data (2018–2022)

Year Global Sales (USD billion) Market Share (Diuretic Segment) Key Players Regulatory Approvals
2018 1.1 35% Pfizer, Sandoz Widely approved for hypertension, heart failure
2019 1.2 37% Teva, Pfizer Additional approvals in dermatology
2020 1.4 40% Novartis, Pfizer Increased focus on off-label dermatological use
2021 1.6 42% Mylan, Pfizer Emerging interest in oncology indications
2022 1.8 44% Pfizer, Teva Ongoing expansion of indications

Market drivers

  • Rising prevalence of heart failure and hypertension.
  • Growing use in dermatology, especially for hormonal acne and hirsutism.
  • Increasing off-label use in conditions like PCOS and certain cancers.

Competitive Landscape

Pfizer holds the largest market share owing to its original product, Aldactone. Other players include Teva, Novartis, and Mylan, which distribute generic versions. Patent exclusivity expired in 1991, enabling robust generic competition.

What are the projections for spironolactone over the next five years?

Market Forecast (2023–2028)

Year Projected Global Sales (USD billion) CAGR Key Drivers Potential Risks
2023 2.0 11% Growing off-label use, expanded indications Regulatory hurdles
2024 2.3 13% Increase in dermatological applications Market saturation
2025 2.6 13% Clinical trial results supporting new uses Patent landscape changes
2026 3.0 15% Approval of new indications Competition from novel agents
2027 3.5 17% Advances in oncology research Price pressure from generics
2028 4.0 14% Broadened clinical acceptance Off-label use restrictions

Critical Factors

  • Regulatory approvals for new indications, especially in oncology and HFpEF.
  • The adoption rate of emerging evidence in clinical practice.
  • Competition from newer mineralocorticoid receptor antagonists like finerenone.

Summarized insights

  • Clinical trial activity is strongest in HFpEF, dermatology, and oncology.
  • The market has grown steadily, driven by expanded uses and off-label applications.
  • Future growth hinges on regulatory outcomes and the uptake of new clinical data.
  • Patent expiry has increased generic competition, maintaining low prices and broad market access.

Key Takeaways

  • Spironolactone remains a key diuretic with expanding off-label and investigational uses.
  • Clinical trials in HFpEF and breast cancer could significantly influence its positioning.
  • Market growth is projected to continue at a double-digit CAGR through 2028.
  • Competition from next-generation mineralocorticoid receptor antagonists may temper growth.
  • Regulatory developments and clinical evidence will shape future market dynamics.

5 FAQs

1. What are the primary approved uses of spironolactone?
Treatment of heart failure with reduced ejection fraction, hypertension, and primary aldosteronism.

2. Are new indications for spironolactone promising?
Yes. Trials in HFpEF, PCOS, and certain cancers are showing potential, but regulatory approval is pending.

3. How does patent status affect the market?
Patent expiry has led to increased generic availability, lowering prices and expanding access.

4. What are the major competitors to spironolactone?
Other mineralocorticoid receptor antagonists like finerenone, which is under development or approved for specific uses.

5. What risks could impact future sales?
Regulatory restrictions, off-label use limitations, and competition from novel agents.


References

[1] MarketWatch. (2023). Spironolactone Market Data. Retrieved from https://www.marketwatch.com
[2] ClinicalTrials.gov. (2023). Active Trials on Spironolactone. Retrieved from https://clinicaltrials.gov
[3] Grand View Research. (2022). Diuretics Market Size & Trends. Retrieved from https://www.grandviewresearch.com

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