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SP

spironolactone (Spiroderm)

✓ Approved

Merck KGaA · NR3C2 · Small Molecule

What is spironolactone?

spironolactone is a small molecule developed by Merck KGaA. It is approved for therapeutic indications via topical.

Drug Profile

Brand NamesSpiroderm
CompanyMerck KGaA
Drug ClassSmall Molecule
Molecular TargetNR3C2, SCNN1A
RouteTopical
StatusApproved

Mechanism of Action

Molecular Targets

spironolactone acts on 2 molecular targets:

NR3C2nuclear receptor subfamily 3 group C member 2 (NR3C2VIT, MR)
SCNN1Asodium channel epithelial 1 subunit alpha (SCNEA, BESC2)
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Therapeutic Indications

spironolactone is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Skin and subcutaneous tissue disordersAcne✓ Approved

Related Research Articles

PubMedActa ophthalmologica2026-07-17

Efficacy and safety of topical macrolides versus systemic tetracyclines for meibomian gland dysfunction-a systematic review and meta-analysis.

Safir Margarita M, Chan Clara C CC, Teichman Joshua C JC, Arbel Itamar I et al.

To review the efficacy and safety of oral doxycycline antibiotics versus topical macrolides in the treatment of meibomian gland dysfunction (MGD). Systematic review and meta-analysis. A comprehensive search of PubMed, Scopus, Embase, and ClinicalTrials.gov through December 2024 identified randomised controlled trials (RCTs) comparing oral tetracyclines with topical macrolides for MGD. Eligible studies reported outcomes related to tear film stability, meibomian gland function, ocular surface health, or symptom severity. Data extraction followed PRISMA guidelines and risk of bias was assessed using Cochrane methods. Among 3699 publications (1964-2024), six RCTs from distinct locations (374 patients) met inclusion criteria, describing only topical azithromycin and oral doxycycline. Treatment regimens were comparable: one month of topical azithromycin (1-1.5%, once to four times daily) versus three to 8 weeks of oral doxycycline (100-200 mg daily). Both treatments significantly improved MGD signs and symptoms. In pooled analyses, topical azithromycin showed superiority in reducing tear debris (odds ratio [OR], 0.33; 95% confidence interval [CI], 0.15-0.74); however, while the total symptoms score favoured azithromycin, the result was borderline (OR, 0.62; 95% CI, 0.38-1.00) and sensitivity-dependent. Subgroup analysis showed doxycycline was superior for corneal fluorescein staining (standardised mean difference [SMD], 0.64; 95% CI, 0.22-1.05), whereas 1% azithromycin was superior for tear breakup time (mean difference [MD], -1.40; 95% CI, -2.20 to -0.60) and dropout-causing adverse events (risk ratio [RR], 0.07; 95% CI, 0.01-0.49). Both topical azithromycin and oral doxycycline are effective for MGD management. Topical azithromycin demonstrated a more favourable safety profile and may represent a useful therapeutic option, particularly for patients with low tolerance to systemic medications. However, further high-quality studies are needed to strengthen the evidence base.

PubMedFrontiers in pediatrics2026-07-17

Case Report: Successful topical simvastatin therapy in a 2-year-old girl with keratin 16-associated palmoplantar epidermal differentiation disorder.

Zhong Qingmei Q, Zhang Ying Y, Feng Zhen Z, Zhang Jinyan J et al.

Palmoplantar epidermal differentiation disorder associated with pachyonychia congenita is a rare autosomal dominant genodermatosis characterized by painful palmoplantar hyperkeratosis and nail dystrophy. Treatment options remain limited, particularly in young children, in whom systemic therapies carry safety concerns. Herein, we report a 2-year-old girl who presented with palmoplantar hyperkeratosis since 1 month of age, with progressive nail dystrophy involving all 20 nails. Whole-exome sequencing identified a hemizygous multi-exon deletion in keratin 16 (ClinVar: SUB16259296; OMIM: #167200), and orthogonal validation using amplicon-based high-throughput sequencing confirmed a 437-nucleotide deletion predicted to result in a frameshift with premature termination codon (PTC). American College of Medical Genetics and Genomics classification supported likely pathogenicity. Twice-daily application of topical 2.5% simvastatin/cholesterol cream for 11 weeks produced substantial improvement in plantar hyperkeratosis, resolution of painful fissures, and visibly improved morphology of nascent nail growth. No local or systemic adverse effects were observed. This case provides preliminary evidence that topical simvastatin may be an effective and well-tolerated therapy for keratin 16-associated palmoplantar epidermal differentiation disorder in young children, and highlights the potential importance of topical drug delivery in achieving therapeutic efficacy for this genetic subtype.

PubMedThe international journal of lower extremity wounds2026-07-17

Comparison of Topical Rifamycin and a Chlorhexidine-Containing Wound Dressing in Infected and Non-Infected Experimental Wound Models.

Türker Kadir Yağız KY, Odabaş Irem Saadet IS, Evirgen Oya O, Yurtçu Ebru Evren EE et al.

AimTo compare topical rifamycin versus a chlorhexidine-containing wound dressing for wound healing and microbial load in infected and non-infected wound models.MethodsThirty rats were studied in two stages across five groups (n = 6). Full-thickness 1 × 2 cm interscapular wounds were created. Group 1 received saline irrigation (control), Group 2 topical rifamycin, Group 3 chlorhexidine-containing dressing (CHD), Group 4 infection with Staphylococcus aureus ATCC 25923 followed by rifamycin, and Group 5 the same infection followed by CHD. Animals were housed individually. On day 7, rats were sacrificed and wounds excised; specimens were divided equally for microbiology and histology.ResultsOn day-7 histology, the control group had the lowest wound healing score (7.66 ± 0.82). The highest score occurred in the CHD group (11.33 ± 1.75), followed by the rifamycin group (10.5 ± 0.55). No significant differences were found between non-infected groups (p = 0.292) or infected groups (p = 0.360). In infected groups, the CHD group showed lower total bacterial colony counts and fewer colonies per milligram of tissue, but differences were not significant (p = 0.091, p = 0.200).ConclusionCHD tended to outperform rifamycin in wound healing and limiting bacterial growth, but no significant difference was detected. This study informs clinical use of both products.

PubMedCureus2026-07-17

Comparative Evaluation of Calendula officinalis and Povidone-Iodine in Facial Wound Healing.

Hammannavar Reshma R, Patil Harshal H, Berad Uday D UD, Borse Ashlesha P AP et al.

Facial wound healing is an important aspect of postoperative care in oral and maxillofacial surgery, because optimal healing is essential for both functional and esthetic outcomes. Topical agents with antimicrobial and anti-inflammatory properties are routinely used to enhance wound healing and to prevent postoperative complications. This study aimed to evaluate and compare the effectiveness of Calendula officinalis tincture and povidone-iodine ointment in the management of facial wounds. This study aimed to compare wound-healing outcomes between the two groups using the Early Wound Healing Score (EHS), evaluate the efficacy of Calendula officinalis tincture in promoting wound healing, assess the efficacy of povidone-iodine ointment in postoperative wound care, compare the incidence of wound infection or dehiscence between the groups, and evaluate patient satisfaction following topical wound management. The primary outcome of this study was the total Early Wound Healing Score (EHS) at day 14, while key secondary outcomes included the clinical signs of inflammation (CSI) score, wound infection rate, and patient satisfaction. This prospective observational clinical study included 64 participants with facial wounds who required postoperative wound care. Participants were divided into two observational groups based on the topical medication prescribed during routine clinical practice. Group A included 32 participants treated with Calendula officinalis tincture, while group B included 32 participants treated with povidone-iodine ointment. Wound healing was assessed using the Early Wound Healing Score (EHS), which included clinical signs of re-epithelialization, hemostasis, and inflammation at baseline and on days three, seven, and 14. Statistical analysis was performed using Mann-Whitney U test, Friedman test, and chi-square test. Statistical significance was set at p < 0.05. The mean age of participants was 31.6 ± 9.4 years in group A and 33.1 ± 10.2 years in group B. Baseline EHS scores were comparable between the groups (p > 0.05). A significant improvement in wound healing was observed in both groups throughout the follow-up period (p < 0.001). However, group A demonstrated significantly higher total EHS scores than group B from day three onwards. At day 14, the mean total EHS was 7.81 ± 0.61 in group A compared to 7.06 ± 0.87 in group B (p = 0.001). Group A also showed significantly better re-epithelialization and lower inflammation scores during follow-up evaluation. Calendula officinalis tincture and povidone-iodine ointment promote satisfactory facial wound healing. However, Calendula officinalis tincture demonstrated superior healing outcomes with improved re-epithelialization and reduced inflammation, suggesting its potential as an effective topical agent for postoperative facial wound management.

PubMedThe Journal of biological chemistry2026-07-17

TIP60 promotes chemoresistance by limiting intracellular platinum accumulation and enhancing removal of cisplatin-DNA adducts.

Hira Akshay A, Craig Michael P MP, McLaughlin Caroline C, Zhang Jin J et al.

Cisplatin resistance is a major barrier to effective treatment of squamous cell carcinoma (SCC) including cutaneous SCC and Head and neck SCC, where resistance develops in more than half of advanced cases. Our previous work demonstrated that genetic knockdown or pharmacological inhibition of TIP60 (KAT5), a histone acetyl transferase, sensitizes cisplatin-resistant SCC cells, induces cell cycle arrest and promotes cell death, suggesting a key role for TIP60 in mediating resistance. Here, we use cisplatin-sensitive and resistant SCC cell lines, together with siRNA-mediated gene silencing, stable overexpression, pharmacological inhibition, immunodot-blot assays, and ICP-MS to demonstrate that TIP60 promotes resistance through two complementary pathways: (1) upregulation of the efflux transporter ABCC1, which reduces intracellular cisplatin accumulation, and (2) increased expression of XPC, a key component of the nucleotide excision repair pathway, involved in recognition and removal of cisplatin-DNA adducts. Elevated TIP60 levels correlate with reduced cisplatin-DNA adduct levels, enhanced removal of cisplatin-DNA adducts and increased cell survival in resistant lines. TIP60 depletion reduces ABCC1 expression and increases cisplatin-DNA adduct levels, effects similarly observed with the ABCC1 inhibitor, MK-571. In parallel, TIP60 knockdown impairs removal of cisplatin-DNA adducts and reduces expression of multiple DNA damage response (DDR) genes, including XPC. Combined inhibition of TIP60 with spironolactone (targeting XPB/NER) or with MK-571further reduces cell survival and increases cell death in resistant cells. These findings establish TIP60 as a regulator of cisplatin resistance that integrates drug efflux and DNA repair pathways, highlighting TIP60 inhibition as a promising therapeutic strategy to overcome platinum resistance in SCC.

PubMedJournal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics2026-07-17

Necroptosis Driven by JAK/STAT-RIPK-MLKL Signaling Mediates Corneal Epithelial Erosion.

Shen Hongyi H, Jin Jiayi J, Zhang Jianqiang J, Shao Wanwen W et al.

Recurrent corneal erosion (RCE) is an ocular surface disease with poor epithelial-stromal adhesion and limited therapies. This study aimed to elucidate the role of necroptosis, a pro-inflammatory form of programmed cell death, in the pathogenesis of corneal erosion. An in vitro UVB injury model was established in human corneal epithelial cells (HCEpiCs), followed by unbiased LC-MS/MS proteomics and pathway enrichment analysis. In parallel, a UVB-induced corneal erosion model was generated in C57BL/6 mice. To test therapeutic relevance, mice received a topical neutralizing anti-IFN-γ antibody or vehicle after injury. Corneal epithelial integrity and stromal architecture were assessed histologically, while activation of IFN-γ-JAK/STAT signaling, RIPK1/RIPK3/MLKL necroptosis, DAMP release, NLRP3 inflammasome assembly, and IL-1β maturation were examined using immunofluorescence, qRT-PCR, and Western blotting. Proteomic profiling showed significant enrichment of necroptosis-related proteins following UVB exposure. UVB-treated corneal epithelium exhibited increased IFN-γ signaling and JAK/STAT activation, accompanied by elevated expression and activation of RIPK1, RIPK3, and MLKL. Necroptosis was associated with increased release of DAMPs, heightened NLRP3 inflammasome activation, and increased maturation/secretion of IL-1β. In vivo, topical anti-IFN-γ treatment reduced corneal epithelial defects, improved epithelial-stromal attachment, and decreased activation markers of the RIPK-MLKL and NLRP3-IL-1β pathways. Our findings unveil a novel and critical pathogenic axis in corneal erosion, where IFN-γ signaling drives a necroptotic-inflammatory loop. This work provides a new molecular framework for understanding corneal epithelial injury and identifies the IFN-γ-necroptosis axis as a promising therapeutic target for RCE.

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