Metolazone
Administration
- Type: Diuretic, Thiazide-like
- Dosage Forms: Tablets (2.5mg, 5mg, 10mg)
- Routes of Administration: PO
- Common Trade Names: Zaroxolyn
Adult Dosing
General
- Edema: 2.5-10mg PO daily
- Hypertension: 2.5-5mg PO daily
Indications by Condition
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Volume overload | 2.5-5mg PO 30min before loop diuretic | Thiazide added for diuretic resistance | PO | Adult |
Pediatric Dosing
General
- 0.2-0.4mg/kg/day PO divided q12-24h
Special Populations
- Pregnancy Rating: B
- Lactation risk: Enters breast milk
Renal Dosing
- Effective even in renal impairment (unlike most thiazides)
Hepatic Dosing
- Use caution in hepatic impairment
Contraindications
- Allergy to class/drug
- Anuria
- Hepatic coma
Adverse Drug Reactions
Serious
- Hypokalemia
- Hyponatremia
- Metabolic alkalosis
Common
- Dizziness
- Headache
- Muscle cramps
Pharmacology
- Onset of action: 1 hour
- Half-life: 14 hours
- Metabolism: Minimal hepatic
- Excretion: Renal (80%)
Mechanism of Action
- Inhibits sodium reabsorption in the distal convoluted tubule
- Synergistic with loop diuretics for diuretic resistance