Pharm

Metolazone

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Metolazone, Zaroxolyn

  • See Also
  1. Thiazide Diuretic
  • Indications
  1. Not typically used for Hypertension
  2. Diuretic Resistance in Edematous States
    1. Congestive Heart Failure
    2. Chronic Kidney Disease
  • Dosing
  • Edema (CHF, renal disease)
  1. Take 30 minutes before Loop Diuretic
  2. Start: 2.5 mg daily (esp. if combined with Loop Diuretic)
  3. Target: 5 to 10 mg orally daily
  4. Maximum: 10 mg/day in CHF (20 mg/day in renal disease)
  • Mechanism
  1. See Thiazide Diuretic
  • Pharmacokinetics
  1. Onset of activity within 1 hour
  2. Duration >24 hours
  • Adverse Effects
  1. See Thiazide Diuretic
  2. Monitor for Electrolyte disturbance (esp. when combined with Loop Diuretics)
  3. Hypovolemia with contraction alkalosis
  4. Hypokalemia
  5. Hyperuricemia
  6. Hyperglycemia
  7. Hyperlipidemia
  8. Hypercalcemia
  • Safety
  1. Unknown Safety in Lactation
  2. Pregnancy Category B
    1. Pregnancy Category D if used for Pregnancy Induced Hypertension
  • Resources
  1. Metolazone (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=6639d111-eb21-4997-b964-f5c61bc088f2
  • References
  1. (2021) Presc Lett, Resource #370507, Commonly Used Diuretics
  2. (2020) Med Lett Drugs Ther 62(1598): 73-80
  3. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 62-3
  4. Hamilton (2020) Tarascon Pocket Pharmacopoeia