Both are prescription. Spiro has generics so its pretty cheap. It is a diuretic used for years for high blood pressure. They discovered it binds to testosterone and helps hair problems and acne. Incidentally, I lost 12 pounds on it :) All water of course, but still... :) And I have to shave my legs less too! Vaniqa is expensive and a lot of insurance companies consider it cosmetic and don't cover it. I'm lucky, mine covers half. But its still $50 a tube! It is a cream that you apply to unwanted hair. Its only approved for face but my endocrinologist and dermatologist both say it is fine to use anywhere.