The drug most commonly used for the task of diminishing one's response to androgens is spironolactone (branded as Aldactone). Like many other drugs in the category of anti-androgen, spironolactone is used other than for its primary or generally intended purpose. In the case of spironolactone, it is a diuretic and anti-hypertensive medication.

Spironolactone is a good choice for an anti-androgen. It is generally well tolerated, even when administered over a period of years. And when by happenstance, a mildly hypertensive patient enters into transgender treatment, often spironolactone can be provided as a substitute; by doing so, the medication now serves a dual purpose. While spironolactone is a potassium saving diuretic, the normal monitoring of blood chemistry during transgender treatment assures its safe administration.

Patients often report increased unpleasant side effects (such as a need for frequent urination) when doses over 300mg per day are taken. Typically doses of 200mg daily or less are well tolerated.

Generic names (Common brand names)

Amiloride (Midamor, Amikal, Amilospare, Arumil, Modamide, Nirulid, Pandiuren) spironolactone (Aldactone, Adultmin, Aldopur, Aldospirone, Almatol, Berlactone, Diatensec, Diram, Esekon, Hypazon, Idrolattone, Merabis, Novospiroton, Osiren, Osyrol, Pirolacton, Resacton, Sincomen, Spiractin, Spiroctan, Spirolacton, Spirolang, Spironex, Spirotone, Tevaspirone, Verospiron, Xenalon Lactabs, Youlactone) triamterene (Dyrenium, Amterene, Diarrol, Diuteren, Dytac, Jatropur, Reviten, Suloton, Triamteril, Trian, Urocaudal)

* This list may not include all brand names.