Metolazone
Metolazone (Zaroxolyn)
Metolazone
(meh- TOH-lah-zohn)
Pregnancy Category: B Mykrox Zaroxolyn (Rx)

Classification: Diuretic, thiazide

See Also: See also Diuretics, Thiazide.

Action/Kinetics: Onset: 1 hr. Peak blood levels, rapid availability tablets: 2-4 hr; t 1/2, elimination: About 14 hr. Peak blood levels, slow availability tablets: 8 hr. Duration, rapid or slow availablity tablets: 24 hr or more. Most excreted unchanged through the urine.

Uses: Slow availability tablets: Edema accompanying CHF; edema accompanying renal diseases, including nephrotic syndrome and conditions of reduced renal function. Alone or in combination with other drugs for the treatment of hypertension.
Rapid availability tablets: Treatment of newly diagnosed mild to moderate hypertension alone or in combination with other drugs. The rapid availability tablets are not to be used to produce diuresis.
Investigational: Alone or as an adjunct to treat calcium nephrolithiasis, premanagement of menstrual syndrome, and adjunct treatment of renal failure.

Contraindications: Anuria, prehepatic and hepatic coma, allergy or hypersensitivity to metolazone. Routine use during pregnancy. Lactation.

Special Concerns: Use with caution in those with severely impaired renal function. Safety and effectiveness have not been determined in children.

Side Effects: See Diuretics, Thiazide. The most commonly reported side effects are dizziness, headache, muscle cramps, malaise, lethargy, lassitude, joint pain/swelling, and chest pain.

Additional Drug Interactions: Alcohol / Hypotensive effect Barbiturates / Hypotensive effect Narcotics / Hypotensive effect NSAIDs / Hypotensive effect of metolazone Salicylates / Hypotensive effect of metolazone

How Supplied: Tablets: 0.5 mg, 2.5 mg, 5 mg, 10 mg.

Dosage
?Slow Availability Tablets Edema due to cardiac failure or renal disease.
Adults: 5-20 mg once daily. For those who experience paroxysmal nocturnal dyspnea, a larger dose may be required to ensure prolonged diuresis and saluresis for a 24-hr period.
Mild to moderate essential hypertension.
Adults: 2.5-5 mg once daily.
?Rapid Availability Tablets Mild to moderate essential hypertension.
Adults, initial: 0.5 mg once daily, usually in the morning. If inadequately controlled, the dose may be increased to 1 mg once a day. Increasing the dose higher than 1 mg does not increase the effect.