Description and Brand Names

Drug information provided by: Micromedex

US Brand Name

  1. Mykrox
  2. Zaroxolyn

Descriptions


Metolazone is used to treat fluid retention (edema) and swelling that is caused by congestive heart failure, kidney disease, or other medical conditions .

Metolazone is also used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the work load of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled .

Metolazone is a thiazide diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps to lower blood pressure .

This medicine is available only with your doctor's prescription .

This product is available in the following dosage forms:

  • Tablet

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of metolazone in the pediatric population. Safety and efficacy have not been established .

Geriatric

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of metolazone in the elderly. However, elderly patients are more likely to have age-related kidney, liver, or heart problems, which may require an adjustment in the dose for patients receiving metolazone .

Pregnancy

Information about this metolazone-oral-route
Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acetyldigoxin
  • Arsenic Trioxide
  • Bepridil
  • Bumetanide
  • Deslanoside
  • Digitalis
  • Digitoxin
  • Digoxin
  • Dofetilide
  • Droperidol
  • Ethacrynic Acid
  • Flecainide
  • Furosemide
  • Ketanserin
  • Levomethadyl
  • Lithium
  • Metildigoxin
  • Sotalol
  • Torsemide

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aceclofenac
  • Acemetacin
  • Alacepril
  • Amtolmetin Guacil
  • Aspirin
  • Benazepril
  • Bromfenac
  • Bufexamac
  • Captopril
  • Celecoxib
  • Choline Salicylate
  • Cilazapril
  • Clonixin
  • Delapril
  • Dexibuprofen
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Dipyrone
  • Enalaprilat
  • Enalapril Maleate
  • Etodolac
  • Etofenamate
  • Etoricoxib
  • Felbinac
  • Fenoprofen
  • Fepradinol
  • Feprazone
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Fosinopril
  • Gossypol
  • Ibuprofen
  • Ibuprofen Lysine
  • Imidapril
  • Indomethacin
  • Ketoprofen
  • Ketorolac
  • Licorice
  • Lisinopril
  • Lornoxicam
  • Loxoprofen
  • Lumiracoxib
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Moexipril
  • Morniflumate
  • Nabumetone
  • Naproxen
  • Nepafenac
  • Niflumic Acid
  • Nimesulide
  • Oxaprozin
  • Oxyphenbutazone
  • Parecoxib
  • Pentopril
  • Perindopril
  • Phenylbutazone
  • Piketoprofen
  • Piroxicam
  • Pranoprofen
  • Proglumetacin
  • Propyphenazone
  • Proquazone
  • Quinapril
  • Ramipril
  • Rofecoxib
  • Salicylic Acid
  • Salsalate
  • Sodium Salicylate
  • Spirapril
  • Sulindac
  • Temocapril
  • Tenoxicam
  • Tiaprofenic Acid
  • Tolfenamic Acid
  • Tolmetin
  • Trandolapril
  • Valdecoxib
  • Zofenopril

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anuria (not able to pass urine) or
  • Liver disease, severe (e.g., hepatic coma)—Should not be used in patients with these conditions .
  • Asthma or
  • Diabetes or
  • Gout or
  • Hypercalcemia (high calcium in the blood) or
  • Hyperuricemia (high uric acid in the blood) or
  • Hypochloremia (low chloride in the blood) or
  • Hypokalemia (low potassium in the blood) or
  • Hypomagnesemia (low magnesium in the blood) or
  • Hyponatremia (low sodium in the blood) or
  • Systemic lupus erythematosus—Use with caution. This medicine may make these conditions worse .
  • Kidney disease or
  • Liver disease—Use with caution. The effects of the medicine may be increased because of slower removal of the medicine from the body .

Proper Use

In addition to the use of this medicine, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium or potassium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet .

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well .

Remember that this medicine will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease .

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way .

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For fluid retention (edema):
      • Adults—At first, 5 to 20 milligrams (mg) once a day. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .
    • For high blood pressure:
      • Adults—At first, 2.5 to 5 milligrams (mg) once a day. Your doctor may adjust your dose if needed.
      • Children—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood or urine tests may be needed to check for unwanted effects .

Check with your doctor right away if you have any of the following symptoms while taking this medicine: convulsions or seizures; decreased urine; drowsiness; dry mouth; excessive thirst; muscle pains or cramps; nausea or vomiting; increased heart rate or pulse; or unusual tiredness or weakness. These may be symptoms of a condition called hypokalemia or potassium loss .

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If the problem continues or gets worse, check with your doctor .

Drinking alcoholic beverages may also make the dizziness, lightheadedness, or fainting worse. While you are taking this medicine, be careful to limit the amount of alcohol you drink .

This medicine may cause changes in your blood sugar levels. If you notice a change in the results of your blood or urine sugar tests or if you have any questions, check with your doctor .

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests (e.g., tests for parathyroid function) may be affected by this medicine .

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements .

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

  1. Black, tarry stools
  2. bleeding gums
  3. blistering, peeling, or loosening of skin
  4. bloating
  5. blood in urine or stools
  6. blurred vision
  7. bone pain
  8. chest pain
  9. chills
  10. clay-colored stools
  11. cold sweats
  12. coma
  13. confusion
  14. constipation
  15. convulsions
  16. cough
  17. dark urine
  18. decreased urine
  19. diarrhea
  20. dizziness, faintness, or lightheadedness when getting up from lying or sitting position
  21. drowsiness
  22. dry mouth
  23. fast, irregular, pounding, or racing heartbeat or pulse
  24. fever
  25. flushed, dry skin
  26. fruit-like breath odor
  27. general tiredness and weakness
  28. headache
  29. incoherent speech
  30. increased hunger
  31. increased thirst
  32. increased urination
  33. indigestion
  34. irritability
  35. itching
  36. joint or muscle pain
  37. light-colored stools
  38. loss of appetite
  39. lower back or side pain
  40. metallic taste
  41. mood changes
  42. muscle pain or cramps
  43. nausea and vomiting
  44. numbness or tingling in hands, feet, or lips
  45. pain in lower legs
  46. painful or difficult urination
  47. pinpoint red spots on skin
  48. rash
  49. red irritated eyes
  50. red skin lesions, often with a purple center
  51. redness or swelling of lower leg
  52. shortness of breath
  53. sore throat
  54. sores, ulcers, or white spots in mouth or on lips
  55. sugar in the urine
  56. sweating
  57. swelling of face, ankles, or hands
  58. swollen or painful glands
  59. tightness in chest
  60. trembling
  61. troubled breathing
  62. unexplained weight loss
  63. unpleasant breath odor
  64. unusual bleeding or bruising
  65. unusual tiredness or weakness
  66. upper right abdominal pain
  67. vomiting of blood
  68. weak pulse
  69. wheezing
  70. yellow eyes and skin

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

  1. Fainting
  2. irregular, fast or slow, or shallow breathing
  3. pale or blue lips, fingernails, or skin
  4. unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  5. weakness and heaviness of legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

  1. Blue-green to black skin discoloration
  2. burning, tingling, numbness, or pain in the hands, arms, feet, or legs
  3. cracked, dry, or scaly skin
  4. decreased interest in sexual intercourse
  5. feeling of constant movement of self or surroundings
  6. hives or welts
  7. inability to have or keep an erection
  8. loss in sexual ability, desire, drive, or performance
  9. pain, redness, or sloughing of skin at place of injection
  10. restlessness
  11. sensation of pins and needles
  12. sensation of spinning
  13. stabbing pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.