Metolazone

Listed in Dosage.

Adult: PO HTN Initial:1.25 mg/day, adjusted after 3-4 wk. Usual range: 2.5-5 mg/day, either alone or w/ other antihypertensives. Maintenance: 5 mg on alternate days. Oedema 5-10 mg/day, up to 20 mg/day if needed. Max: 80 mg/24 hr.

Should be taken with food. Take after breakfast.

Anuria; hepatic coma or pre-coma. Pregnancy.

Pre-diabetes or DM; gout; SLE; hepatic and renal impairment; hypercholesterolaemia. Correct electrolyte disturbances prior to therapy. Risk of cross-sensitivity with sulfonamides, sulfonylureas, carbonic anhydrase inhibitors, thiazides and loop diuretics. Lactation.

Chest pain, palpitation, necrotising angiitis, orthostatic hypotension, syncope, venous thrombosis, vertigo, volume depletion; depression, dizziness, chills, drowsiness, fatigue, restlessness, headache, lightheadedness; petechiae, photosensitivity, hypersensitivity reactions; gout attacks, electrolyte disturbances; abdominal bloating, diarrhoea, abdominal pain, anorexia, constipation, epigastric distress, nausea, xerostomia, pancreatitis, vomiting; impotence; aplastic anaemia, thrombocytopenia, haemoconcentration, leukopenia; cholestatic jaundice, hepatitis; joint pain, muscle cramps, weakness, neuropathy, paraesthesia; blurred vision; increased BUN, glucosuria.
Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis.

Hypotensive and nephrotoxic effects of ACE inhibitors may be enhanced. Absorption may be reduced with bile acid sequestrants. Hyperglycaemic effect may be enhanced with diazoxide. May increase serum concentration and QTc-prolonging effect of dofetilide. May reduce lithium excretion. Hypotensive effect may be increased with alcohol.

Diuretics

C03BA08 - metolazone ; Belongs to the class of low-ceiling sulfonamide diuretics.