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At a glance

Metolazone is a thiazide-like diuretic used to treat hypertension and edema (fluid overload) associated with heart, liver, kidney, or lung disease.

Indications
  • Hypertension (high blood pressure)
  • Edema (fluid overload) associated with heart failure, liver, kidney, or lung disease
  • Edema associated with nephrotic syndrome
  • Edema associated with renal disease
Pharmacology

Metolazone is a quinazoline diuretic with properties generally similar to thiazide diuretics. It acts primarily to inhibit sodium reabsorption at the cortical diluting site and to a lesser extent in the proximal convoluted tubule. Sodium and chloride ions are excreted in approximately equivalent amounts. It does not inhibit carbonic anhydrase.

Dosage

Adult Dose (Oral):

  • Hypertension: Initial: 1.25 mg daily; adjusted after 3-4 weeks; Maintenance: 2.5-5 mg daily
  • Edema (Heart Failure): 5-10 mg daily; increased if necessary to 20 mg daily; Max: 80 mg in 24 hr
  • Edema (Renal Disease): 5-20 mg daily
  • Elderly: Initial: 2.5 mg/day or every other day

Child Dose: 0.2-0.4 mg/kg/day (single daily dose or divided q12hr)

Side effects

Common Side Effects:

  • Headache
  • Nausea
  • Increased blood uric acid
  • Decreased potassium level in blood
  • Glucose intolerance
  • Altered blood lipid level
  • Dizziness

Serious Side Effects:

  • Hyponatremia (sudden drop of sodium level)
  • Hypokalemia (potassium loss)
  • Hyperuricemia
  • Orthostatic hypotension
  • Pancreatitis
  • Hepatitis
Use in pregnancy

Use in Pregnancy: Generally considered safe. Animal studies show low or no adverse effects on developing baby; limited human studies.

Pregnancy Category: B — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • Caution while driving (may cause dizziness, blurred vision)
  • Take in the morning with breakfast (to avoid nighttime urination)
  • Avoid alcohol (may increase dizziness)
  • Monitor kidney function and electrolytes regularly
  • Monitor blood pressure regularly
  • Caution in diabetes, gout, SLE
  • Caution in hepatic and renal impairment
Overdose effects

Overdose may cause excessive diuresis, electrolyte disturbances, hypotension. Symptomatic treatment.

Storage conditions

Keep below 30°C temperature, away from light & moisture. Keep out of reach of children.

Metolazone — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.