Generic Name: Metolazone Brand Name(s): Generics only. No brands available.

Uses

What is Metolazone used for?

Metolazone is a “water pill” (diuretic) that increases the amount of urine you make, which causes your body to get rid of excess water. This drug is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.

This medication also reduces swelling/fluid retention (edema) which can result from conditions such as congestive heart failure or kidney disease. This can help to improve symptoms such as trouble breathing.

How should I take Metolazone?

Take this medication by mouth with or without food, usually once daily, or as directed by your doctor. The dosage is based on your medical condition and response to therapy.

If you take this drug too close to bedtime, you may need to wake up to urinate. Therefore, 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. It is important to continue 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 3-6 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 persists or worsens, contact your doctor or pharmacist.

How do I store Metolazone?

Metolazone is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Metolazone in the bathroom or the freezer. There may be different brands of Metolazone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Metolazone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Metolazone?

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.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe kidney disease (inability to make urine or anuria).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, untreated mineral imbalance (e.g., 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 that you are taking this medication.

This drug may make you dizzy or blur your vision. Alcohol or marijuana 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.

To minimize dizziness and lightheadedness, get up slowly when rising from a seated or lying position.

Caution is advised when using this drug in the elderly because they may be more sensitive to its effects, especially dizziness.

Metolazone should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor.

This drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Metolazone during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Metolazone. Metolazone is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Metolazone?

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 persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she 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 excessive loss of body water and minerals (including potassium). Tell your doctor right away if you have any of these unlikely but serious symptoms of dehydration or mineral loss: 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 any of these unlikely but serious side effects occur: numbness/tingling of the arms/legs, decreased sexual ability.

Tell your doctor right away if any of these highly unlikely but very serious side effects occur: persistent sore throat or fever, easy bleeding or bruising, stomach/abdominal pain, persistent nausea/vomiting, yellowing of eyes/skin, signs of kidney problems (such as change in the amount of urine).

Get medical help right away if you have any very serious side effects, including: decrease in vision, eye pain.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Metolazone?

This drug should not be used with the following medications because very serious interactions may occur: cisapride.

If you are currently using any of these medications, tell your doctor or pharmacist before starting metolazone.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: 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 (e.g., parathyroid function tests). Make sure laboratory personnel and your doctors know you use this drug.

Metolazone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Metolazone?

Metolazone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Metolazone?

Metolazone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Metolazone.

What is the dose of Metolazone for an adult?

Usual Adult Dose for Hypertension

Initial dose: 2.5 mg orally once a day (Zaroxolyn) or

0.5 mg orally once a day (Mykrox).

Usual Adult Dose for Edema

Initial dose: 5 mg orally once a day (Zaroxolyn) or

0.5 mg orally once a day (Mykrox).

Dose Adjustments

The initial Zaroxolyn or Mykrox dose may be doubled in 3 days to control hypertension or reduce edema.

High dose metolazone may be required in patients with severe renal dysfunction.

Dialysis

Metolazone is not dialyzable by hemo- or peritoneal dialysis.

Other Comments

The maximum recommended daily dose for Zaroxolyn is 5 mg for hypertension and 20 mg for edema.

The maximum recommended daily dose for Mykrox is 1 mg.

Periodic monitoring of electrolytes is recommended, particularly in elderly patients and in patients receiving a high dose.

What is the dose of Metolazone for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Metolazone available?

Metolazone is available in the following dosage forms and strengths:

  • Oral Tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Metolazone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: March 29, 2018 | Last Modified: March 29, 2018

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