Uses

Indicated for the treatment of salt and water retention including edema accompanying congestive heart failure and renal diseases (including nephrotic syndrome). Also indicated for the treatment of hypertension, alone or in combination with other antihypertensive agents.

Do not use if

Contraindicated in patients with anuria, hepatic coma or pre-coma, and known hypersensitivity or allergy to metolazone.

Side effects

Adverse effects include electrolyte imbalances (hypokalemia, hyponatremia, hypomagnesemia), hyperuricemia, hyperglycemia, dizziness, and orthostatic hypotension. Gastrointestinal complaints, nausea, and diarrhea may occur.

Warnings

Rapid-onset severe hyponatremia and/or hypokalemia have been reported following initial doses. Monitor electrolytes closely, especially in patients on digitalis or corticosteroids. Cross-sensitivity with sulfonamide-derived drugs is possible.

How it works

Metolazone is a quinazoline diuretic with properties similar to thiazide diuretics. It inhibits sodium reabsorption at the cortical diluting site of the distal tubule and, to a lesser extent, the proximal convoluted tubule. This increases urinary excretion of sodium, chloride, and water.

Storage

Store at controlled room temperature, 20°C to 25°C. Protect from light and moisture. Dispense in tight, light-resistant containers.