II. Indications

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

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)
  3. Hypovolemia with contraction alkalosis
  4. Hypokalemia
  5. Hyperuricemia
  6. Hyperglycemia
  7. Hyperlipidemia
  8. Hypercalcemia

VII. Safety

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

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

Ontology: Metolazone (C0025854)

Definition (MSH) A quinazoline-sulfonamide derived DIURETIC that functions by inhibiting SODIUM CHLORIDE SYMPORTERS.
Definition (NCI) A long acting, quinazoline-based sulfonamide thiazide-like, diuretic. Similar to the thiazides, metolazone acts on the distal convoluted tubule (DCT) and inhibits the sodium-chloride symporter, thereby preventing sodium and chloride reabsorption and excretion of water.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008788
SnomedCT 22198003, 387123003
LNC LP17954-6, MTHU003340
English Metolazone, 6-Quinazolinesulfonamide, 7-chloro-1,2,3,4-tetrahydro-2-methyl-3-(2-methylphenyl)-4-oxo-, 2-Methyl-3-o-tolyl-6-sulfamyl-7-chloro-1,2,3,4-tetrahydro-4-quinazolinone, 7-Chloro-1,2,3,4-tetrahydro-2-methyl-3-(2-methylphenyl)-4-oxo-6-quinazolinesulfonamide, 7-Chloro-1,2,3,4-tetrahydro-2-methyl-4-oxo-3-o-tolyl-6-quinazolinesulfonamide, metolazone, metolazone (medication), METOLAZONE, Metolazone [Chemical/Ingredient], Metolazone (product), Metolazone (substance)
Swedish Metolazon
Czech metolazon
Finnish Metolatsoni
Russian METOLAZON, МЕТОЛАЗОН
Japanese メトラゾン
Polish Metolazon
Spanish metolazona (producto), metolazona (sustancia), metolazona, Metolazona
French Métolazone
German Metolazon
Italian Metolazone
Portuguese Metolazona

Ontology: Zaroxolyn (C0701383)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D008788
English zaroxolyn, UCB Pharma Brand of Metolazone, Zaroxolyn