Metolazone
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Questions & Answers
Side Effects & Adverse Reactions
Rarely, the rapid onset of severe hyponatremia and/or hypokalemia has been reported following initial doses of thiazide and non-thiazide diuretics. When symptoms consistent with severe electrolyte imbalance appear rapidly, drug should be discontinued and supportive measures should be initiated immediately. Parenteral electrolytes may be required. Appropriateness of therapy with this class of drugs should be carefully reevaluated.
Hypokalemia may occur with consequent weakness, cramps, and cardiac dysrhythmias. Serum potassium should be determined at regular and appropriate intervals, and dose reduction, potassium supplementation or addition of a potassium-sparing diuretic instituted whenever indicated. Hypokalemia is a particular hazard in patients who are digitalized or who have or have had a ventricular arrhythmia; dangerous or fatal arrhythmias may be precipitated. Hypokalemia is dose related.
In general, diuretics should not be given concomitantly with lithium because they reduce its renal clearance and add a high risk of lithium toxicity. Read prescribing information for lithium preparations before use of such concomitant therapy.
Unusually large or prolonged losses of fluids and electrolytes may result when metolazone is administered concomitantly to patients receiving furosemide (see PRECAUTIONS, Drug Interactions).
When metolazone is used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy.
Cross-allergy may occur when metolazone is given to patients known to be allergic to sulfonamide-derived drugs, thiazides, or quinethazone.
Sensitivity reactions (e.g., angioedema, bronchospasm) may occur with or without a history of allergy or bronchial asthma and may occur with the first dose of metolazone.
Legal Issues
There is currently no legal information available for this drug.
FDA Safety Alerts
There are currently no FDA safety alerts available for this drug.
Manufacturer Warnings
There is currently no manufacturer warning information available for this drug.
FDA Labeling Changes
There are currently no FDA labeling changes available for this drug.
Uses
Metolazone tablets USP are indicated for the treatment of salt and water retention including:
• edema accompanying congestive heart failure;
• edema accompanying renal diseases, including the nephrotic syndrome and states of diminished renal function.
Metolazone tablets USP are also indicated for the treatment of hypertension, alone or in combination with other antihypertensive drugs of a different class. Mykrox® tablets, a more rapidly available form of metolazone, are intended for the treatment of new patients with mild to moderate hypertension. A dose titration is necessary if Mykrox® tablets are to be substituted for Zaroxolyn® tablets and other formulations of metolazone that share its slow and incomplete bioavailability, in the treatment of hypertension.
The routine use of diuretics in an otherwise healthy woman is inappropriate and exposes mother and fetus to unnecessary hazard. Diuretics do not prevent development of toxemia of pregnancy, and there is no evidence that they are useful in the treatment of developed toxemia.
Edema during pregnancy may arise from pathologic causes or from the physiologic and mechanical consequence of pregnancy. Metolazone tablets USP are indicated in pregnancy when edema is due to pathologic causes, just as it is in the absence of pregnancy (see PRECAUTIONS). Dependent edema in pregnancy resulting from restriction of venous return by the expanded uterus is properly treated through elevation of the lower extremities and use of support hose; use of diuretics to lower intravascular volume in this case is illogical and unnecessary. There is hypervolemia during normal pregnancy which is harmful to neither the fetus nor the mother (in the absence of cardiovascular disease), but which is associated with edema, including generalized edema, in the majority of pregnant women. If this edema produces discomfort, increased recumbency will often provide relief. In rare instances, this edema may cause extreme discomfort which is not relieved by rest. In these cases, a short course of diuretics may be appropriate.
History
There is currently no drug history available for this drug.
Other Information
Metolazone Tablets USP for oral administration contain 2.5 mg, 5 mg or 10 mg of metolazone USP, a diuretic/saluretic/antihypertensive drug of the quinazoline class.
Metolazone has the molecular formula C16H16ClN3O3S, the chemical name 7-chloro-1,2,3,4-tetrahydro-2-methyl-4-oxo-3-o-tolyl-6-quinazolinesulfonamide, and a molecular weight of 365.84. The structural formula is:
Metolazone is only sparingly soluble in water, but more soluble in plasma, blood, alkali, and organic solvents.
Inactive Ingredients: colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose and dye: 2.5 mg - D&C red No. 30 and FD&C blue No. 2; 5 mg - FD&C blue No. 2; 10 mg - D&C yellow No. 10 and FD&C yellow No. 6.
Sources
Metolazone Manufacturers
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Eon Labs, Inc.
![Metolazone Tablet [Eon Labs, Inc.]](/wp-content/themes/bootstrap/assets/img/loading2.gif)
Metolazone | Eon Labs, Inc.
Effective dosage of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage SchedulesSuitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone tablets, 5 mg to 20 mg once daily.
Edema of renal disease:
Metolazone tablets, 5 mg to 20 mg once daily.
Mild to moderate essential hypertension:
Metolazone tablets, 2.5 mg to 5 mg once daily.
New patients - If considered desirable to switch patients currently on Zaroxolyn® tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox®, the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed.
Treatment of Edematous StatesThe time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient's condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of HypertensionThe time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
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Physicians Total Care, Inc.
Metolazone | Physicians Total Care, Inc.
Effective dosage of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage SchedulesSuitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone tablets, 5 mg to 20 mg once daily.
Edema of renal disease:
Metolazone tablets, 5 mg to 20 mg once daily.
Mild to moderate essential hypertension:
Metolazone tablets, 2.5 mg to 5 mg once daily.
New patients - If considered desirable to switch patients currently on Zaroxolyn® tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox®, the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed.
Treatment of Edematous StatesThe time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient's condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of HypertensionThe time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
-
Ncs Healthcare Of Ky, Inc Dba Vangard Labs
Metolazone | Ncs Healthcare Of Ky, Inc Dba Vangard Labs
Effective dosage of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage SchedulesSuitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone tablets 5 to 20 mg once daily.Edema of renal disease:
Metolazone tablets 5 to 20 mg once daily.Mild to moderate essential hypertension:
Metolazone tablets 2.5 to 5 mg once daily.
New patients- If considered desirable to switch patients currently on Zaroxolyn® tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox®, the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed. Treatment of Edematous StatesThe time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient's condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone tablets, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of HypertensionThe time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
-
Mckesson Packaging Services A Business Unit Of Mckesson Corporation
Metolazone | Mckesson Packaging Services A Business Unit Of Mckesson Corporation
Effective dosage of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage SchedulesSuitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone tablets, 5 mg to 20 mg once daily.
Edema of renal disease:
Metolazone tablets, 5 mg to 20 mg once daily.
Mild to moderate essential hypertension:
Metolazone tablets, 2.5 mg to 5 mg once daily.
New patients - If considered desirable to switch patients currently on Zaroxolyn® tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox®, the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed.
Treatment of Edematous StatesThe time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient's condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of HypertensionThe time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
-
Ncs Healthcare Of Ky, Inc Dba Vangard Labs
Metolazone | Ncs Healthcare Of Ky, Inc Dba Vangard Labs
Effective doses of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage Schedules:
Suitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone Tablets USP, 5 mg to 20 mg once daily.
Edema of renal disease:
Metolazone Tablets USP, 5 mg to 20 mg once daily.
Mild to moderate essential hypertension:
Metolazone Tablets USP, 2.5 mg to 5 mg once daily.
New patients - If considered desirable to switch patients currently on Zaroxolyn® tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox®, the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed.
Treatment of Edematous States:
The time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient"s condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone tablets USP, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of Hypertension:
The time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
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Upstate Pharma, Llc
Metolazone | Apotheca Company
DIRECTIONS: 10 drops orally, 3 times a day or as directed by a health care professional. Consult a physician for use in children under 12 years of age.
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Mylan Pharmaceuticals Inc.
Metolazone | Mylan Pharmaceuticals Inc.
Effective dosage of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage SchedulesSuitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone tablets 5 to 20 mg once daily.Edema of renal disease:
Metolazone tablets 5 to 20 mg once daily.Mild to moderate essential hypertension:
Metolazone tablets 2.5 to 5 mg once daily.
New patients- If considered desirable to switch patients currently on Zaroxolyn ® tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox ®, the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed. Treatment of Edematous StatesThe time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient's condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone tablets, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of HypertensionThe time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
-
Carilion Materials Management
Metolazone | Carilion Materials Management
Effective dosage of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage SchedulesSuitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone tablets 5 to 20 mg once daily.Edema of renal disease:
Metolazone tablets 5 to 20 mg once daily.Mild to moderate essential hypertension:
Metolazone tablets 2.5 to 5 mg once daily. New patients- If considered desirable to switch patients currently on Zaroxolyn tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox , the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed.
® ® Treatment of Edematous StatesThe time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient's condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone tablets, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of HypertensionThe time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
-
Mylan Institutional Inc.
Metolazone | Mylan Institutional Inc.
Effective dosage of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage SchedulesSuitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone tablets 5 to 20 mg once daily.Edema of renal disease:
Metolazone tablets 5 to 20 mg once daily.Mild to moderate essential hypertension:
Metolazone tablets 2.5 to 5 mg once daily.
New patients- If considered desirable to switch patients currently on Zaroxolyn ® tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox ®, the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed. Treatment of Edematous StatesThe time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient's condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone tablets, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of HypertensionThe time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
-
Cardinal Health
Metolazone | Cardinal Health
Effective dosage of metolazone tablets should be individualized according to indication and patient response. A single daily dose is recommended. Therapy with metolazone tablets should be titrated to gain an initial therapeutic response and to determine the minimal dose possible to maintain the desired therapeutic response.
Usual Single Daily Dosage SchedulesSuitable initial dosages will usually fall in the ranges given.
Edema of cardiac failure:
Metolazone tablets 5 to 20 mg once daily.Edema of renal disease:
Metolazone tablets 5 to 20 mg once daily.Mild to moderate essential hypertension:
Metolazone tablets 2.5 to 5 mg once daily.
New patients- If considered desirable to switch patients currently on Zaroxolyn ® tablets and other formulations of metolazone that share its slow and incomplete bioavailability to Mykrox ®, the dose should be determined by titration starting at one tablet (0.5 mg) once daily and increasing to two tablets (1 mg) once daily if needed. Treatment of Edematous StatesThe time interval required for the initial dosage to produce an effect may vary. Diuresis and saluresis usually begin within one hour and persist for 24 hours or longer. When a desired therapeutic effect has been obtained, it may be advisable to reduce the dose if possible. The daily dose depends on the severity of the patient's condition, sodium intake, and responsiveness. A decision to change the daily dose should be based on the results of thorough clinical and laboratory evaluations. If antihypertensive drugs or diuretics are given concurrently with metolazone tablets, more careful dosage adjustment may be necessary. For patients who tend to experience paroxysmal nocturnal dyspnea, it may be advisable to employ a larger dose to ensure prolongation of diuresis and saluresis for a full 24-hour period.
Treatment of HypertensionThe time interval required for the initial dosage regimen to show effect may vary from three or four days to three to six weeks in the treatment of elevated blood pressure. Doses should be adjusted at appropriate intervals to achieve maximum therapeutic effect.
![Metolazone Tablet [Physicians Total Care, Inc.]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=78105e5c-5d36-426c-9f79-f2e085460b75&name=5056.jpg)
![Metolazone Tablet [Ncs Healthcare Of Ky, Inc Dba Vangard Labs]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=449ebee4-6feb-428b-8cae-9bb0a49d1d3d&name=metolazone-tablets-2.jpg)
![Metolazone Tablet [Mckesson Packaging Services A Business Unit Of Mckesson Corporation]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=4813f476-3637-4f0f-abdd-c76c4074f8ae&name=4813f476-3637-4f0f-abdd-c76c4074f8ae-02.jpg)
![Metolazone Tablet [Ncs Healthcare Of Ky, Inc Dba Vangard Labs]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=e15d3b19-062c-4a0c-b618-008277056853&name=metolazone-5mg-2.jpg)
![Metolazone Tablet [Upstate Pharma, Llc]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=1e4c4404-7e4c-4bab-800e-de356968d8c1&name=mm1.jpg)
![Metolazone Tablet [Mylan Pharmaceuticals Inc.]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=6639d111-eb21-4997-b964-f5c61bc088f2&name=c04007fa-98b6-4de3-ba2f-6a2301c3e427-02.jpg)
![Metolazone Tablet [Carilion Materials Management]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=e535c22d-ffe7-4adc-b188-9efe4cb580a9&name=68151-2939.jpg)
![Metolazone Tablet [Mylan Institutional Inc.]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=e5fe856e-7fd6-47fb-87f7-7c1c621f50a0&name=image-01.jpg)
![Metolazone Tablet [Cardinal Health]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=c893c914-6195-45fa-a2bc-4e8b78004737&name=image-01.jpg)
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