What is metolazone. Metolazone: Uses, Side Effects, and Precautions for Effective Blood Pressure Management
How does metolazone work to lower blood pressure. What are the common side effects of taking metolazone. When should you consult your doctor about metolazone use. How can metolazone affect diabetes and electrolyte balance. What precautions should be taken when using metolazone.
Understanding Metolazone: A Comprehensive Guide to This Blood Pressure Medication
Metolazone is a prescription medication primarily used to treat high blood pressure and fluid retention. As a thiazide-like diuretic, it works by helping the body eliminate excess water and salt through urine. This action not only reduces blood pressure but also alleviates edema associated with various medical conditions.
Key Points About Metolazone:
- Primarily used for hypertension and edema
- Belongs to the thiazide-like diuretic class
- Increases urine production to remove excess fluid
- May take 3-6 weeks to fully lower blood pressure
- Available as an oral medication
Proper Usage and Dosage Guidelines for Metolazone
Adhering to the prescribed dosage and administration instructions is crucial for maximizing the benefits of metolazone while minimizing potential side effects. Your healthcare provider will determine the appropriate dosage based on your individual needs and medical condition.
How should metolazone be taken?
Metolazone is typically taken orally once daily, with or without food. To avoid nighttime urination, it’s best to take the medication at least 4 hours before bedtime. Consistency in timing is important, so try to take it at the same time each day.
Can metolazone be stopped abruptly?
No, it’s essential to continue taking metolazone as prescribed, even if you feel well. Abruptly stopping the medication can lead to a sudden increase in blood pressure. Always consult your doctor before making any changes to your medication regimen.
Potential Side Effects and Monitoring Considerations
While metolazone is generally well-tolerated, it’s important to be aware of potential side effects and know when to seek medical attention. Some side effects may occur as your body adjusts to the medication, while others may require immediate medical intervention.
Common Side Effects:
- Dizziness
- Lightheadedness
- Headache
- Blurred vision
- Loss of appetite
- Stomach upset
- Diarrhea or constipation
These side effects often subside as your body adjusts to the medication. However, if they persist or worsen, it’s important to inform your healthcare provider.
Serious Side Effects Requiring Immediate Attention:
- Severe dizziness or fainting
- Irregular heartbeat
- Severe nausea or vomiting
- Persistent sore throat or fever
- Numbness or tingling in extremities
- Yellowing of eyes or skin
- Signs of kidney problems (changes in urination)
- Vision changes or eye pain
If you experience any of these serious side effects, seek medical attention promptly.
Metolazone’s Impact on Electrolyte Balance and Dehydration
One of the primary concerns when using metolazone is its potential to disrupt the body’s electrolyte balance and cause dehydration. Understanding these risks and recognizing the signs of imbalance is crucial for safe medication use.
How does metolazone affect electrolyte balance?
Metolazone works by increasing urine output, which can lead to the loss of important electrolytes such as sodium, potassium, and magnesium. This loss can result in electrolyte imbalances if not properly managed.
Signs of Electrolyte Imbalance and Dehydration:
- Muscle cramps or weakness
- Confusion
- Severe dizziness
- Unusual dry mouth or thirst
- Persistent nausea or vomiting
- Fast or irregular heartbeat
- Seizures
If you experience any of these symptoms, it’s important to contact your healthcare provider immediately. They may need to adjust your medication or recommend electrolyte supplements.
Metolazone and Diabetes: Special Considerations
For individuals with diabetes, metolazone use requires additional monitoring and potential adjustments to diabetes management. The medication can affect blood sugar levels, necessitating closer attention to glucose control.
How does metolazone affect blood sugar?
Metolazone can potentially raise blood sugar levels in some individuals. This effect is thought to be due to its impact on insulin sensitivity and glucose metabolism.
Managing Diabetes While Taking Metolazone:
- Monitor blood sugar levels regularly and as directed by your healthcare provider
- Report any significant changes in blood sugar patterns to your doctor
- Be aware of symptoms of high blood sugar, such as increased thirst and urination
- Your doctor may need to adjust your diabetes medications or management plan
- Maintain a consistent diet and exercise routine as recommended by your healthcare team
Open communication with your healthcare provider is essential to ensure proper management of both your blood pressure and diabetes while taking metolazone.
Drug Interactions and Precautions with Metolazone
Metolazone can interact with various medications and supplements, potentially altering its effectiveness or increasing the risk of side effects. Additionally, certain medical conditions may require special precautions when using this medication.
Important Drug Interactions:
- Cholestyramine and colestipol: These medications can decrease metolazone absorption. Separate dosing by at least 4 hours for cholestyramine and 2 hours for colestipol.
- Other blood pressure medications: May enhance the blood pressure-lowering effects
- Lithium: Metolazone can increase lithium levels in the blood
- NSAIDs: May reduce the effectiveness of metolazone
- Digoxin: Metolazone can increase the risk of digoxin toxicity
Medical Conditions Requiring Caution:
- Kidney disease
- Liver disease
- Gout
- Lupus
- History of allergic reactions to sulfa drugs
Always inform your healthcare provider about all medications, supplements, and medical conditions before starting metolazone.
Lifestyle Considerations While Taking Metolazone
While metolazone can effectively manage blood pressure, certain lifestyle adjustments may be necessary to ensure safe and optimal use of the medication.
Sun Sensitivity:
Metolazone can increase skin sensitivity to sunlight. To protect yourself:
- Limit sun exposure, especially during peak hours
- Use broad-spectrum sunscreen with high SPF
- Wear protective clothing when outdoors
- Avoid tanning beds and sunlamps
Alcohol and Cannabis Use:
Both alcohol and cannabis can enhance the dizziness and lightheadedness associated with metolazone. It’s advisable to limit or avoid these substances while taking the medication. Always consult your healthcare provider about safe alcohol consumption.
Physical Activities and Driving:
Metolazone may cause dizziness or blurred vision, especially when first starting the medication. Exercise caution when performing activities that require alertness or clear vision, such as driving or operating machinery, until you know how the medication affects you.
Special Populations and Metolazone Use
Certain groups may require special considerations when using metolazone. Understanding these specific needs can help ensure safe and effective treatment.
Older Adults:
Elderly individuals may be more sensitive to the side effects of metolazone, particularly dizziness and electrolyte imbalances. Closer monitoring and potentially lower starting doses may be necessary.
Pregnancy and Breastfeeding:
The safety of metolazone during pregnancy and breastfeeding is not well-established. It’s crucial to discuss the potential risks and benefits with your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding.
Children:
Metolazone use in children should be carefully monitored, as they may be more sensitive to its effects. Dosing is typically based on weight and individual response to the medication.
In all cases, close communication with your healthcare provider is essential to ensure appropriate use and monitoring of metolazone in these special populations.
Long-Term Management and Follow-Up with Metolazone
Successful long-term management of hypertension with metolazone requires ongoing monitoring and regular follow-up with your healthcare provider. This ensures the medication remains effective and safe over time.
Regular Check-ups and Monitoring:
- Blood pressure measurements
- Blood tests to check electrolyte levels and kidney function
- Evaluation of side effects and overall medication effectiveness
- Adjustments to dosage or treatment plan as needed
Complementary Lifestyle Measures:
To enhance the effectiveness of metolazone and support overall cardiovascular health, consider incorporating these lifestyle measures:
- Maintain a healthy, low-sodium diet
- Engage in regular physical activity as approved by your doctor
- Manage stress through relaxation techniques or mindfulness practices
- Quit smoking if applicable
- Limit alcohol consumption
Remember, metolazone is just one part of a comprehensive approach to managing hypertension. Working closely with your healthcare team and adhering to both medication and lifestyle recommendations can help you achieve optimal blood pressure control and overall health.
Metolazone Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Uses
How to use Metolazone
Take this medication by mouth with or without food as directed by your doctor, usually once daily. The dosage is based on your medical condition and response to treatment.
If you take this drug too close to bedtime, you may need to wake up to urinate. It is best to take this medication at least 4 hours before your bedtime.
Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day as directed. Keep taking this medication even if you feel well. Most people with high blood pressure do not feel sick. Do not stop taking this medication without consulting your doctor. It may take up to 3 to 6 weeks to see a lowering of your blood pressure.
Cholestyramine and colestipol can decrease the absorption of metolazone. If you are taking either of these drugs, separate metolazone from cholestyramine by at least 4 hours and from colestipol by at least 2 hours.
If your condition lasts or gets worse, tell your doctor or pharmacist.
Side Effects
Dizziness, lightheadedness, headache, blurred vision, loss of appetite, stomach upset, diarrhea, or constipation may occur as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
This medication may lead to dehydration and electrolyte imbalance. Tell your doctor right away if you have any of these unlikely but serious symptoms of dehydration or electrolyte imbalance: muscle cramps or weakness, confusion, severe dizziness, unusual dry mouth or thirst, nausea or vomiting, fast/irregular heartbeat, fainting, seizures.
Tell your doctor right away if you have any serious side effects, including: nausea/vomiting that doesn’t stop, sore throat or fever that doesn’t go away, numbness/tingling of the arms/legs, decreased sexual ability, easy bleeding or bruising, stomach/abdominal pain, yellowing of eyes/skin, signs of kidney problems (such as change in the amount of urine), decrease in vision, eye pain.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Precautions
Before taking metolazone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, untreated mineral imbalance (such as sodium, potassium), gout, lupus.
If you have diabetes, metolazone may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. Your doctor may need to adjust your diabetes medication, exercise program, or diet.
This drug may reduce the potassium levels in your blood. Ask your doctor about adding potassium to your diet. A potassium supplement may be prescribed by your doctor.
This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This drug may make you dizzy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.
Older adults may be more sensitive to the side effects of this drug, especially dizziness.
During pregnancy, metolazone should be used only when clearly needed. Discuss the risks and benefits with your doctor.
This drug passes into breast milk. Consult your doctor before breast-feeding.
Interactions
See also the How to Use section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist.
Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Some products that may interact with this drug include: cholestyramine, colestipol, diazoxide, digoxin, dofetilide, lithium.
Some products have ingredients that could raise your blood pressure or worsen your swelling. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).
This product can affect the results of certain lab tests (such as parathyroid function tests). Make sure laboratory personnel and your doctors know you use this drug.
Does Metolazone interact with other drugs you are taking?
Enter your medication into the WebMD interaction checker
Overdose
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222.
Canada residents can call a provincial poison control center. Symptoms of overdose may include fainting, severe weakness, a severe decrease in amount of urine, or slow or shallow breathing.
Do not share this medication with others.
Lifestyle changes such as stress reduction programs, exercise, and dietary changes may increase the effectiveness of this medicine. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.
Lab and/or medical tests (such as blood mineral levels such as potassium, kidney/liver function) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
Have your blood pressure checked regularly while taking this medication. Discuss with your doctor how to monitor your own blood pressure.
If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Images
metolazone 2.5 mg tablet
Color: pinkShape: roundImprint: 643 2 1/2
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 5 mg tablet
Color: whiteShape: roundImprint: 25 logo
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 10 mg tablet
Color: yellowShape: roundImprint: 27 logo
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 2.5 mg tablet
Color: whiteShape: roundImprint: 17 logo
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 5 mg tablet
Color: blueShape: ovalImprint: logo and 55
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 2.5 mg tablet
Color: pinkShape: ovalImprint: Logo and 50
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 5 mg tablet
Color: blueShape: roundImprint: M 5
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 5 mg tablet
Color: blueShape: roundImprint: 644 5
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 2.5 mg tablet
Color: pinkShape: roundImprint: M 2 1/2
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 10 mg tablet
Color: yellowShape: roundImprint: 645 10
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 10 mg tablet
Color: yellowShape: ovalImprint: E 56
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 10 mg tablet
Color: yellowShape: roundImprint: M 10
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 5 mg tablet
Color: orangeShape: roundImprint: M 173
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 2.5 mg tablet
Color: peachShape: roundImprint: M 172
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
metolazone 10 mg tablet
Color: light greenShape: roundImprint: M 174
This medicine is a pink, round, tablet imprinted with “643” and “2 1/2”.
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Drug Survey
Are you currently using Metolazone?
This survey is being conducted by the WebMD marketing sciences department.
Selected from data included with permission and copyrighted by First Databank, Inc.
This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.
CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.
Side Effects, Dosage, Uses & More
Highlights for metolazone
- Metolazone oral tablet is available as both a generic and brand-name drug. Brand name: Zaroxolyn.
- The most common side effects of metolazone are constipation, dry mouth, diarrhea, headache, stomach pain, and blurred vision.
- Metolazone is used to treat high blood pressure (hypertension) and the buildup of excess fluid and salt in your body (edema).
- Low sodium and potassium levels warning: In rare cases, taking metolazone has suddenly led to low sodium levels (hyponatremia) or low potassium levels (hypokalemia) or both. If this occurs, your doctor may have you stop using metolazone.
- High nitrogen levels warning: Metolazone can cause high levels of nitrogen in your body (azotemia). If you have kidney disease, and experience high levels of nitrogen in your body or you’re having trouble urinating (or are not urinating as often), then your doctor will stop treatment with metolazone.
- Low blood pressure when standing warning: Metolazone can cause low blood pressure when you stand up (orthostatic hypotension).
Metolazone oral tablet is a prescription drug that’s available as the brand-name drug Zaroxolyn.
It’s also available as a generic drug. Generic drugs usually cost less. In some cases, they may not be available in every strength or form as the brand.
Why it’s used
Metolazone is used to treat high blood pressure. It’s also used to treat the buildup of excess fluid and salt in your body. Metolazone may be taken as part of a combination therapy with other medications.
How it works
Metolazone belongs to a class of drugs called diuretics. A class of drugs is a group of medications that work in a similar way. They’re often used to treat similar conditions. Diuretics work by causing you to urinate more. This helps remove excess fluid and salt from your body. Removing this excess fluid and salt also helps to lower your blood pressure.
Metolazone oral tablet doesn’t cause drowsiness. However, it can cause other side effects. Mild side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
More common side effects
The most common side effects that occur with metolazone include:
- abdominal pain
- blurred vision
- constipation
- diarrhea
- dry mouth
- headache
Serious side effects
Call your doctor right away if you have any of these serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
- Allergic reactions. Symptoms can include:
- rash
- hives
- itching
- raised welts
- facial swelling
- fever
- difficulty breathing
- peeling or blistering skin
- Heart problems. Symptoms can include:
- irregular heartbeat
- chest pain
- Liver problems. Symptoms can include:
- yellowing of the whites of your eyes or your skin
- weakness or tiredness
- abdominal pain
- nausea
- vomiting
- Nerve problems. Symptoms can include:
- muscle pain or cramps
- numbness in your hands or feet
Disclaimer: Our goal is to provide you with the most relevant and current information.
However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
Metolazone oral tablet can interact with other medications, herbs, or vitamins you might be taking. An interaction is when a substance changes the way a drug works. This can be harmful or cause the drugs that you take to not work as well. To help prevent interactions, your doctor should manage all of your medications carefully. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.
Examples of drugs that can cause interactions with metolazone are listed below.
Antibiotics
Taking certain antibiotics with metolazone can make metolazone not work as well. These include:
- methenamine
Other blood pressure drugs
These drugs can lower your blood pressure too much if taken with metolazone.:max_bytes(150000):strip_icc()/soluble-and-insoluble-fiber-1087462-21c72678948c413183c75d95374b9342.png)
They include:
- angiotensin-converting enzyme (ACE) inhibitors, such as:
- benazepril
- captopril
- enalapril
- enalaprilat
- fosinopril
- moexipril
- perindopril
- quinapril
- ramipril
- trandolapril
- angiotensin II receptor blockers (ARBs), such as:
- irbesartan
- losartan
- olmesartan
- telmisartan
- valsartan
- beta-blockers, such as:
- acebutolol
- atenolol
- betaxolol
- bisoprolol
- esmolol
- metoprolol
- nadolol
- nebivolol
- penbutolol
- pindolol
- propranolol
- timolol (systemic)
- calcium channel blockers, such as:
- amlodipine
- felodipine
- nicardipine
- nifedipine
- direct renin inhibitors, such as:
- aliskiren
- loop diuretics, such as:
- bumetanide
- furosemide
- indapamide
- torsemide
- potassium-sparing diuretics, such as:
- eplerenone
- spironolactone
- triamterene
Blood thinners (anticoagulants)
Your dose of these drugs may need to be increased if you’re taking them with metolazone.
When you take them with metolazone, they may not work as well. These drugs include:
- warfarin
Corticosteroids
Taking these medications with metolazone may increase your risk for hypokalemia (low sodium). These include:
- prednisone
- prednisolone
- methylprednisolone
Diabetes drugs
Your dose of these drugs may need to be increased if you’re taking them with metolazone. When you take them with metolazone, they may not work as well. These drugs include:
- insulin
Diuretics
Taking these drugs with metolazone may increase your risk for low sodium levels (hypokalemia). These include:
- furosemide
Heart drugs
Metolazone may increase the effects of these drugs. These drugs include:
- digoxin
Mood stabilizers
Metolazone may increase the effects of these drugs. These drugs include:
- lithium
Pain drugs
Taking the following pain drugs with metolazone can make metolazone not work as well:
- aspirin
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as:
- diclofenac
- ibuprofen
- indomethacin
- ketoprofen
- ketorolac
- meloxicam
- nabumetone
- naproxen
- piroxicam
- COX-2 Inhibitors
- celecoxib
Taking the following pain drugs with metolazone can lower your blood pressure too much:
- barbiturates, such as:
- butabarbital
- butalbital
- methohextal
- pentobarbital
- phenobarbital
- secobarbital
- thiopental
- narcotics, such as:
- codeine
- dihydrocodeine
- fentanyl
- hydrocodone
- hydromorphone
- levorphanol
- mepiridine
- methadone
- morphine
- opium
- oxycodone
- oxymorphone
- tramadol
Disclaimer: Our goal is to provide you with the most relevant and current information.
However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Metolazone oral tablet comes with several warnings.
Allergy warning
Metolazone can cause a severe allergic reaction. Symptoms can include:
- trouble breathing
- swelling of your throat or tongue
- hives
Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).
Alcohol interaction
Drinking alcohol while you take this drug can increase your risk for low blood pressure when you stand up (orthostatic hypotension).
Warnings for people with certain health conditions
For people with anuria: If your body isn’t able to make urine (anuria), you shouldn’t take metolazone.
Metolazone is removed from your body by your kidneys. If your kidneys aren’t working well, this will make it harder for your body to get rid of the drug.
For people with liver failure: You shouldn’t take metolazone if you have advanced stages of liver failure. Metolazone can cause changes to your electrolyte levels, which may bring on a hepatic coma in people with liver disease.
For people with diabetes: Metolazone can increase your blood sugar level. Talk to your doctor before using this drug if you have diabetes.
For people with gout: Metolazone can increase the amount of acid in your body. This can cause gouty attacks.
For people with kidney disease: Metolazone is eliminated from your body through your kidneys and can build up in your body if your kidneys aren’t working as well as they should. This can lead to toxicity. Tell your doctor if you have kidney disease or kidney damage.
For people with systemic lupus erythematosus: Taking metolazone may make your systemic lupus erythematosus worse.
Warnings for other groups
For pregnant women: Metolazone is a category B pregnancy drug. That means two things:
- Studies of the drug in pregnant animals haven’t shown risk to the fetus.
- There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus.
Speak with your doctor if you’re pregnant or planning to become pregnant. Metolazone should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus.
Women who are breastfeeding: Metolazone may pass into breast milk and can cause serious adverse effects. Talk to your doctor before taking metolazone if you’re breast-feeding or plan to breastfeed.
For children: This medicine shouldn’t be used in people younger than 18 years.
This dosage information is for metolazone oral tablet. All possible dosages and forms may not be included here. Your doctor will tell you what dosage is right for you.
Your dose, form, and how often you take it will depend on:
- your age
- the condition being treated
- how severe your condition is
- other medical conditions you have
- how you react to the first dose
Forms and strengths
Generic: metolazone
- Form: Oral tablet
- Strengths: 2.5 mg, 5 mg, 10 mg
Brand: Zaroxolyn
- Form: Oral tablet
- Strengths: 2.5 mg, 5 mg, 10 mg
Dosage for hypertension
Adult dosage (ages 18 years and older)
The usual dose for mild to moderate hypertension is 2.5–5 mg by mouth, once per day.
Child dosage (ages 0–17 years)
This medicine hasn’t been studied in children and shouldn’t be used in people younger than 18 years.
Dosage for edema
Adult dosage (ages 18 years and older)
The usual dose for edema is 5–20 mg by mouth, once per day.
Child dosage (ages 0–17 years)
This medicine hasn’t been studied in children and shouldn’t be used in people younger than 18 years.
Special considerations
People with kidney disease: If you have kidney disease, you may need a lower dose or you may need a different dosing schedule. Metolazone is removed from your body by your kidneys. It can build up in your body if your kidneys aren’t working as well as they should. This can lead to toxicity.
People with heart disease: If you have heart disease or decreased heart function you may need a lower dose or you may need a different dosing schedule.
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.
Metolazone oral tablet is used for short-term or long-term therapy. For swelling and water retention in your legs and arms, metolazone is used as short-term therapy. For high blood pressure, it’s used as long-term therapy. It comes with serious risks if you don’t take it as prescribed.
If you don’t take it at all: If you don’t take metolazone at all, your blood pressure or edema, or both, might not be controlled. This may lead to a heart attack, stroke, pain, or infection.
If you stop taking it suddenly: If you’re taking metolazone for high blood pressure and suddenly stop taking it, you may experience rebound high blood pressure. This is a sudden increase in your blood pressure after you stop taking your blood pressure medication. Symptoms of rebound hypertension include headache, confusion, chest pain, sweating, nausea, and vomiting.
If you don’t take it on schedule: If you don’t take metolazone according to the schedule for your doses, it may not work as well.
In order for this drug to work, you need a consistent amount of it in your body at all times.
If you take too much: Taking too much metolazone can cause dizziness, drowsiness, fainting spells, low blood pressure when you stand up, changes in your electrolytes, and trouble breathing. If you think you have taken too much metolazone, you should go to the nearest emergency room or contact poison control right away.
What to do if you miss a dose: If you forget to take your dose, take it as soon as you remember, unless you remember just a few hours before the time for your next dose. Then only take one dose. Never try to catch up by taking two doses at once. This could result in toxic side effects.
How to tell if the drug is working: You may or may not be able to tell if metolazone is working; however, your doctor will check your blood pressure and fluid volume regularly to see if they’re at normal levels and controlled. You also may purchase a blood pressure monitor from your local pharmacy so that you can check your blood pressure yourself.
Keep these considerations in mind if your doctor prescribes metolazone oral tablet for you.
General
- Metolazone can be taken with or without food.
- Metolazone should be taken early in the day. This helps to avoid frequent urination throughout the night.
- Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead.
Storage
- Keep it between 68°F (20ºC) and 77°F (25°C).
- Don’t freeze metolazone.
- Keep it away from light and high temperature.
- Keep your drugs away from areas where they could get wet, such as bathrooms. Store these drugs away from moisture and damp locations.
Refills
A prescription for this medication is refillable.You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.
Travel
When traveling with your medication:
- Always carry your medication with you, such as in your carry-on bag.
- Don’t worry about airport X-ray machines. They can’t hurt your medication.
- You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
- Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.
Self-management
You may need to buy a blood pressure monitor. These can be purchased at most pharmacies.
Clinical monitoring
While you’re taking metolazone, your doctor will regularly monitor your electrolyte levels, blood sugar level, blood acid levels, calcium levels, heart function, liver function, and kidney function.
Sun sensitivity
Metolazone can make your skin more sensitive to the sun. This increases your risk of sunburn. Avoid the sun if you can. If you can’t, be sure to wear protective clothing and apply sunscreen.
Insurance
Many insurance companies require a prior authorization for this drug.
This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.
There are other drugs available. Some may be better for you than others. Talk to your doctor about other options that may work for you.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
Metolazone – instructions for use
metolazone
Instruction:
- Pharmacological action
- Pharmacokinetics
- Readings
- Contraindications
- With care
- Pregnancy and breastfeeding
- Dosage and Administration
- Side effects
- Overdose
- Interaction
- Transport management
- Sports medicine
- Classification
Pharmacological action
Metolazone is a thiazide diuretic.
Suppresses sodium reabsorption in the distal tubules, causing increased excretion of water and sodium, potassium and hydrogen ions.
Pharmacokinetics
Absorption and distribution
Bioavailability is about 40-65%. Onset of action: diuresis, ~60 minutes. Duration of action: ≥24 hours.
Time to reach maximum plasma concentration (TC max ) – 8 hours.
Communication with plasma proteins – 95%.
Biotransformation and excretion
Metolazone is slightly metabolized. 70-95% is excreted unchanged in the urine due to glomerular filtration and active tubular secretion.
Half-life (T ½ ) – 20 hours.
Elimination – with urine (80%), with bile (10%).
Indications
Mild to moderate hypertension, edema in heart failure, nephrotic syndrome and conditions of reduced kidney function.
Contraindications
- Hypersensitivity to metolazone;
- anuria;
- hepatic coma or precoma.
With caution
- Diabetes,
- hypercholesterolemia,
- hyperuricemia,
- gout,
- hypotension,
- systemic lupus erythematosus,
- sympathectomy,
- liver diseases.
Pregnancy and breastfeeding
Use in pregnancy
FDA fetal category B.
Adequate and strictly controlled studies on the safety of metolazone during pregnancy in humans have not been conducted. Metolazone crosses the placental barrier.
Animal studies have not shown evidence of teratogenicity.
In the event of pregnancy, absence of menstruation or suspected possible pregnancy, the patient should inform her physician.
The use of metolazone in pregnant women is contraindicated unless the potential benefit to the mother outweighs the possible risk to the fetus.
Use during breastfeeding
Special studies on the safety of the use of metolazone during breastfeeding have not been conducted.
Metolazone is excreted in breast milk. A risk to the infant cannot be ruled out.
Should stop breastfeeding if necessary to use the drug.
Dosage and administration
Orally (by mouth).
Children
200-400 mcg/kg/day in 1-2 divided doses.
Adults
Edema: 5-20 mg once daily.
Arterial hypertension: 2.5-5 mg once a day.
Side effects
Generally well tolerated, most adverse reactions reported were mild and transient.
Frequency not determined: chest pain, depression, dizziness, drowsiness, electrolyte disturbances, glucosuria, gout attacks, headache, hemoconcentration, hepatotoxicity, hyperuricemia, hypochloremic alkalosis, hypokalemia, hypomagnesemia, hyponatremia, hypophosphatemia, hyperglycemia, hypercalcemia, decreased libido, increased blood urea nitrogen, joint pain, leukopenia, necrotizing angiitis, neuropathy, nocturia, orthostatic hypotension, palpitations, pancreatitis, anxiety, Stevens-Johnson syndrome, syncope, toxic epidermal necrolysis, urticaria, venous thrombosis.
Overdose
Symptoms: labored breathing, dizziness, drowsiness, fainting, gastrointestinal irritation, lethargy leading to coma.
Interaction
The combined use of metolazone with aymaline increases the risk of cholestasis.
Alfuzosin may increase the hypotensive effect of drugs that lower blood pressure.
When used concomitantly, thiazide diuretics may increase the likelihood of allergic or hypersensitivity reactions to allopurinol and may increase the serum concentration of oxypurinol, the active metabolite of allopurinol.
Blood pressure lowering drugs may increase the hypotensive effect of amifostine.
Co-administration of metolazone with aminolevulinic acid may enhance the photosensitizing effect of aminolevulinic acid.
When used in combination with amphetamines, the antihypertensive effect of metolazone may be reduced.
Thiazide diuretics may increase the hypotensive and nephrotoxic effects of angiotensin-converting enzyme inhibitors.
Anticholinergics may increase the serum concentration of thiazide diuretics.
When used concomitantly, thiazide diuretics may reduce the therapeutic effect of antidiabetic agents.
Barbiturates may enhance the hypotensive effect of drugs that lower blood pressure.
With the simultaneous use of benperidol with antihypertensive drugs, the effect of antihypertensive drugs is enhanced.
Beta 2 -agonists may enhance the hypokalemic effect of thiazide diuretics.
Brigatinib may reduce the antihypertensive effect and increase the bradycardia effect of antihypertensive agents.
Metolazone may increase the bradycardial effect of drugs that cause bradycardia.
Brimonidine may enhance the hypotensive effect of antihypertensive drugs.
Blood pressure lowering drugs may enhance the hypotensive effect of bromperidol. Bromperidol may reduce the antihypertensive effect of blood pressure lowering agents.
Photosensitizing agents may enhance the photosensitizing effect of verteporfin.
Thiazide diuretics may increase the hypercalcemic effect of vitamin D analogues.
Thiazide diuretics may reduce the excretion of calcium salts. Simultaneous intake with calcium salts can lead to metabolic alkalosis.
Co-administration of carbamazepine with diuretics may lead to symptomatic hyponatremia.
Due to the hypokalemic and hypomagnesemic action, thiazide diuretics can enhance the adverse / toxic effects of cardiac glycosides.
Corticosteroids may enhance the hypokalemic effect of thiazide diuretics.
Thiazide diuretics may increase the adverse/toxic effects of cyclophosphamide (potentiation of granulocytopenia is possible).
Dexketoprofen may increase the toxic effects of sulfonamides.
Co-administration of dexmethylphenidate may reduce the therapeutic effect of antihypertensive agents.
Co-administration of diacerein may enhance the therapeutic effect of diuretics and may increase the risk of dehydration or hypokalemia.
Diazoxide may enhance the antihypertensive effect of blood pressure lowering agents.
Thiazide diuretics may increase the adverse/toxic effects of diazoxide.
Thiazide diuretics may enhance the hypokalemic effect of dichlorphenamide.
Thiazide diuretics may increase the plasma concentration of dofetilide and increase its QT prolongation effect.
Antihypertensive agents may increase the hypotensive effect of duloxetine.
Thiazide diuretics may increase the arrhythmogenic effect of fexinidazole.
Herbal medicines with hypertensive properties may reduce the antihypertensive effect of antihypertensive drugs.
Herbal medicines with antihypertensive properties may enhance the hypotensive effect of blood pressure lowering agents.
Ipragliflozin may enhance the effects of diuretics and also increase the risks associated with their use, such as the risk of dehydration and hypotension.
Yohimbine may reduce the antihypertensive effect of antihypertensive drugs.
Bile acid sequestrants may reduce the absorption of thiazide diuretics and reduce the diuretic response.
Thiazide diuretics may increase the arrhythmogenic effect of ivabradine.
Antihypertensive agents may enhance the hypotensive effect of levodopa.
Thiazide diuretics may increase the adverse/toxic effects of levosulpiride.
The simultaneous use of thiazide diuretics with licorice is not recommended due to the risk of hypokalemia.
Thiazide diuretics may reduce lithium excretion.
Co-administration of lormetazepam may enhance the hypotensive effect of antihypertensive agents.
Thiazide diuretics may increase the severity of adverse reactions of mecamylamine.
Thiazide diuretics reduce the effectiveness of methenamine.
Methylphenidate may reduce the hypotensive effect of antihypertensive drugs.
With the simultaneous appointment of molsidomine with antihypertensive drugs, the hypotensive effect is enhanced.
Thiazide diuretics may enhance the hypotensive effect and QTc effect of arsenic trioxide.
Naftopidil may enhance the hypotensive effect of antihypertensive drugs.
Nicergoline enhances the effect of antihypertensive drugs.
Co-administration of nicorandil may potentiate the effects of antihypertensive agents.
Antihypertensive drugs may enhance the hypotensive effect of nitroprusside.
Thiazide diuretics may increase the nephrotoxic effect of NSAIDs. NSAIDs may reduce the therapeutic effect of thiazide diuretics.
Co-administration of obinutuzumab may enhance the effects of antihypertensive agents.
Opioid agonists may increase the severity of adverse reactions and reduce the therapeutic effect of diuretics.
Thiazide diuretics may increase the risk of hyponatremia when used concomitantly with oxcarbazepine.
Prostacyclin analogues may increase the effect of antihypertensive drugs.
Photosensitizing agents may increase the photosensitizing effect of the porfimer.
Co-administration with pentoxifylline may enhance the effect of antihypertensive drugs.
Thiazide diuretics may increase plasma concentrations and enhance the hypokalemic effect of topiramate.
Thiazide diuretics may increase the hypercalcemic effect of toremifene.
Phosphodiesterase 5 inhibitors may increase the effect of antihypertensive drugs.
The combination of promazine with antihypertensive drugs can lead to severe orthostatic hypotension.
Reboxetine may enhance the hypokalemic effect of thiazide diuretics.
Antihypertensive drugs may enhance the hypotensive effect of folcodine.
Quinagolide may enhance the effect of antihypertensive drugs.
Selective serotonin reuptake inhibitors may enhance the hyponatremic effect of thiazide diuretics.
Diuretics may increase the nephrotoxic effect of sodium phosphates and increase the risk of acute phosphate nephropathy.
Ethanol may enhance the orthostatic hypotensive effect of thiazide diuretics.
Influence on the ability to drive vehicles and control mechanisms
It is necessary to refrain from driving vehicles and engaging in activities that require increased concentration of attention and speed of psychomotor reactions.
Sports medicine
Metolazone may cause anti-doping rule violations and positive results in doping controls.
Metolazone belongs to class S5 “Diuretics and masking agents” of the WADA Prohibited List.
⚠ Prohibited substances should not be used to enhance athletic performance as they pose a serious health risk. |
NOTE: Detection in an athlete’s sample at any time or in-competition, as the case may be, of any number of substances that are authorized for use while meeting the threshold concentration level, for example: formoterol, salbutamol, cathine, ephedrine, methylephedrine and pseudoephedrine, in combination with a diuretic or masking agent will be considered an Adverse Analytical Finding (AAF) unless the Athlete has an approved Therapeutic Use Exemption (TUE) for that substance in addition to a Therapeutic Use Exemption for the diuretic.
Glossary
| Term | Description |
|---|---|
| WADA | World Anti-Doping Agency |
The instructions are not intended to replace professional medical advice, diagnosis or treatment. The information contained here may change over time. The most accurate information on the use of drugs containing the active substance Metolazone is contained in the manufacturer’s instructions attached to the package.
At the same time, cellular aging is one of the main processes leading to wear and tear of body tissues and general aging of the body.
Thus, by the color of the fluorescence of animals, biologists determined whether the response to protein misfolding was triggered.