Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Greece: Metenix, Zaroxolyn; Italy: Zaroxolyn; Portugal: Diulo; UK: Metenix.

North America

Canada: Zaroxolyn; USA: Metolazone, Zaroxolyn.

Drug combinations


Metolazone: C~16~H~16~ClN~3~O~3~S. Mw: 365.83. (1) 6-Quinazolinesulfonamide, 7-chloro-1,2,3,4-tetrahydro-2-methyl-3-(2-methylphenyl)-4-oxo-; (2) 7-Chloro-1,2,3,4-tetrahydro-2-methyl-4-oxo-3-o-tolyl-6-quinazolinesulfonamide. CAS-17560-51-9 (1968).

Pharmacologic Category

Thiazide-like Diuretics. (ATC-Code: C03BA08).

Mechanism of action

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


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.



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