Inhibits sodium reabsorption in distal tubules causing increased excretion of sodium and water, as well as potassium and hydrogen ions.
Therapeutic use
Management of mild to moderate hypertension. Treatment of edema in congestive heart failure and nephrotic syndrome, impaired renal function.
Pregnancy and lactiation implications
Crosses placenta. Hypoglycemia, hypokalemia, hyponatremia, jaundice, and thrombocytopenia reported as complications to fetus or newborn following maternal use of thiazide diuretics. Use not recommended during lactation.
Unlabeled use
Contraindications
Hypersensitivity to metolazone, any component of the formulation, other thiazides, and sulfonamide derivatives. Anuria. Hepatic coma. Pregnancy.
Warnings and precautions
Hypokalemia, hypochloremic alkalosis, and hyponatremia can occur. Photosensitization might occur. Use in thiazide or sulfonamide allergy contraindicated. Use with caution in prediabetes or diabetes mellitus (change in glucose control might be seen). Gout can be precipitated in certain patients. Use with caution in severe hepatic dysfunction, in moderate or high cholesterol concentrations, and in hypokalemia. Avoid in severe renal disease (ineffective). Can cause systemic lupus erythematosus exacerbation or activation. Large or prolonged fluid and electrolyte losses may occur with concomitant furosemide administration.