Metolazone

Aka: Metolazone, Zaroxolyn

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II. Indications

  1. Not typically used for Hypertension
  2. Diuretic Resistance in Edematous States
    1. Congestive Heart Failure
    2. Chronic Kidney Disease

III. 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)

IV. Mechanism

  1. See Thiazide Diuretic

V. Pharmacokinetics

  1. Onset of activity within 1 hour
  2. Duration >24 hours

VI. Adverse Effects

  1. See Thiazide Diuretic
  2. Monitor for Electrolyte disturbance (esp. when combined with Loop Diuretics)

VII. Safety

  1. Unknown Safety in Lactation
  2. Pregnancy Category B
    1. Pregnancy Category D if used for Pregnancy Induced Hypertension

VIII. Resources: Metolazone (DailyMed)

  1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=6639d111-eb21-4997-b964-f5c61bc088f2

IX. 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

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Related Studies

Cost: Medications

metolazone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
METOLAZONE 10 MG TABLET Generic $0.81 each
METOLAZONE 2.5 MG TABLET Generic $0.52 each
METOLAZONE 5 MG TABLET Generic $0.80 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

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