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Metolazone: Brands, Price & Uses in Bangladesh
Metolazone is a thiazide-like diuretic used in the following settings: Established / FDA-approved uses Hypertension: Metolazone is indicated alone or in combination with other antihypertensive…
About Metolazone
Indications of Metolazone
Metolazone is a thiazide-like diuretic used in the following settings:
Established / FDA-approved uses
- Hypertension: Metolazone is indicated alone or in combination with other antihypertensive agents for the management of essential hypertension.
- Edema: Metolazone is indicated for the treatment of salt and water retention (edema) associated with congestive heart failure, and edema associated with renal disease, including the nephrotic syndrome.
Guideline-supported / adjunct (combination therapy) uses
- Diuretic-resistant edema: Metolazone is frequently combined with a loop diuretic (e.g., furosemide) under specialist supervision to achieve sequential nephron blockade in patients with diuretic resistance, such as those with advanced heart failure or chronic kidney disease. This combination produces a potent synergistic diuretic effect and requires close monitoring.
Metolazone should only be used for indications and durations established by a qualified physician.
Dosage & Administration of Metolazone
Dosage of Metolazone must be individualized by a physician based on indication, response, and renal/hepatic function.
| Indication | Adult Dose | Notes |
|---|---|---|
| Hypertension | Initially 2.5 mg once daily; may be increased to 5 mg once daily if needed | Reassess periodically; combine with other antihypertensives as needed |
| Edema (heart failure, renal disease including nephrotic syndrome) | 5 mg to 20 mg once daily | Dose titrated to clinical response |
| Resistant edema (combination with loop diuretics) | Low dose (e.g., 2.5-5 mg), often given intermittently, 30-60 minutes before the loop diuretic dose | Off-label, specialist-supervised use; requires close monitoring of electrolytes, renal function, and volume status due to potent synergistic effect |
Renal impairment: Metolazone can be used with caution at more advanced degrees of renal impairment than many other thiazide diuretics, but renal function and electrolytes must be monitored closely.
Hepatic impairment: Use with caution; contraindicated in hepatic coma or precoma (see Contraindications).
See Administration for instructions on how to take Metolazone, and Precautions and Warnings for monitoring requirements.
Side Effects of Metolazone
Common and important side effects associated with Metolazone include:
- Dizziness, lightheadedness, or headache
- Hypotension (low blood pressure), especially with volume depletion
- Electrolyte disturbances: hypokalemia, hyponatremia, hypomagnesemia, hypochloremic alkalosis
- Hyperuricemia (may precipitate gout attacks)
- Hyperglycemia
- Muscle cramps or weakness
- Gastrointestinal upset (nausea, vomiting, abdominal discomfort)
- Skin rash or photosensitivity (uncommon)
- Blood dyscrasias (rare)
Seek prompt medical attention for signs of severe electrolyte imbalance (e.g., muscle cramps, severe weakness, irregular heartbeat, confusion) while taking Metolazone.
Contraindications of Metolazone
Metolazone is contraindicated in:
- Anuria (absence of urine production)
- Hepatic coma or precoma
- Known hypersensitivity to Metolazone or to other sulfonamide-derived drugs (thiazide-like structure; relative caution per class labeling)
Metolazone should not be used in patients meeting any of the above criteria. Other cautions (e.g., electrolyte disturbances, renal impairment) are addressed under Precautions and Warnings, not as absolute contraindications.
Frequently Asked Questions about Metolazone
What is Metolazone used for?
Metolazone is a thiazide-like diuretic used to treat high blood pressure and edema (fluid retention) associated with conditions such as heart failure and kidney disease, including nephrotic syndrome. It is also used, under specialist supervision, in combination with loop diuretics for edema that is resistant to treatment.
How should I take Metolazone?
Take Metolazone exactly as prescribed by your physician, usually once daily in the morning, with or without food. Do not change your dose or stop taking Metolazone without consulting your doctor.
What are the common side effects of Metolazone?
Common side effects of Metolazone include dizziness, low blood pressure, electrolyte disturbances (such as low potassium, sodium, or magnesium), increased uric acid levels, elevated blood sugar, muscle cramps, and gastrointestinal upset. Contact your doctor if you experience severe weakness, irregular heartbeat, or confusion.
Who should not take Metolazone?
Metolazone should not be used by people with anuria (no urine production), hepatic coma or precoma, or known hypersensitivity to Metolazone or other sulfonamide-derived drugs. Discuss your full medical history with your doctor before starting Metolazone.
Can Metolazone be taken during pregnancy or breastfeeding?
Metolazone should be used during pregnancy only if clearly needed, as the potential benefit must be weighed against potential risk to the fetus; it is not recommended for routine treatment of pregnancy-related swelling. It is also excreted in breast milk in small amounts, so breastfeeding mothers should use Metolazone only under medical supervision. Always consult your physician.
Does Metolazone interact with other medicines?
Yes. Metolazone can interact with lithium (increasing lithium toxicity risk), loop diuretics (synergistic but potentially excessive diuretic effect), NSAIDs, digoxin, antidiabetic medications, and other blood-pressure-lowering drugs. Always tell your doctor about all medications you are taking before starting Metolazone.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.