Which diuretic is primarily known for antiandrogen effects?

• A. Spironolactone
• B. Triamterene
• C. Mannitol
• D. Furosemide

Answer: (A)

Spironolactone is the diuretic best known for antiandrogen effects. Its steroidal structure allows it to interact with androgen pathways by both antagonizing androgen receptors and inhibiting enzymes involved in androgen synthesis, which reduces androgen activity. This antiandrogen action underpins its use in conditions like hirsutism or acne in women. The other diuretics listed do not have meaningful antiandrogen activity: triamterene blocks sodium channels in the distal nephron, mannitol acts as an osmotic diuretic, and furosemide is a loop diuretic.