Metolazone Pharmacology


About Metolazone
A thiazide-like diuretic, Symporter inhibitor, Diuretic, Antihypertensive.
Mechanism of Action of Metolazone
It exerts thiazide like diuretic action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+ excretion. It also inhibits PO4 reabsorption in proximal tubules. It also has minor carbonic anhydrase inhibitory action. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.

Pharmacokinets of Metolazone
Absorption: It is absorbed orally up to 65%.Distribution: It is about 70% erythrocyte-bound and 30% protein bound. Metabolism: It is not significantly metabolized in the body. Excretion: Excreted mainly through urine as unchanged drug
Onset of Action for Metolazone
1 hour
Duration of Action for Metolazone
18 to 24 hours
Half Life of Metolazone
14 hours
Side Effects of Metolazone
1.Gastrointestinal disturbances
7.Muscle cramps
10.Carbohydrate intolerance
15.Abdominal pain
Contra-indications of Metolazone
1.Renal impairment
2.Hepatic impairment
4.Hypersensitivity to the drug
5.Hyper sensitivity to sulfonamides
Special Precautions while taking Metolazone
1.Renal impairment
2.Hepatic diseases
3.Avoid exposure to sun light as much as possible to prevent photosensitivity
4.Hyper urecaemia and Gout
5.Diabetes mellitus
6.Monitor and correct Fluid and electrolyte imbalance
9.Systemic lupus erythematosus
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Children Related Information
Indications for Metolazone
3.Congestive heart failure

Interactions for Metolazone
Loop diuretics like furosemide, bumetanide and digoxin : Metolazone can lower blood potassium and magnesium levels. This is especially true in patients who are also taking ?loop? diuretics such as furosemide, bumetanide, torsemide. Low potassium and magnesium levels can lead to heart rhythm abnormalities, especially in patients already taking digoxin.
Blood uric acid levels can increase during metolazone treatment, but precipitation of gout due to the increase is rare.
Lithium : Metolazone reduces excretion by the kidneys of lithium and can lead to lithium toxicity in patients being treated with lithium.
NSAIDs : Nsaids such as ibuprofen, naproxen and nabumetone can reduce the effectiveness of metolazone by interfering with the excretion of salt and water.
Alcohol: Alcohol may increase the side effects of metolazone
Typical Dosage for Metolazone
2.5 to 10mg/day as a single or two divided doses. Increased if required to 20mg/day.
Rapid acting tablets: 0.5mg 0rally as once daily dosage
Maximum dose: 1gm/ day (for rapid acting tablets)

Schedule of Metolazone
Storage Requirements for Metolazone
Store at a cool dry place away from light and at a temperature below 30 degree C. in a well closed container. Keep out of reach of children.
Effects of Missed Dosage of Metolazone
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose
Effects of Overdose of Metolazone
Treatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.

Home Delivery for Metolazone in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including metolazone.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for metolazone and other medicines and health products. Home delivery services for metolazone may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take metolazone only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for metolazone before they complete the sale. You can get this information while placing the order for metolazone with the pharmacy.

Metolazone is a generic medicine name and there are several brands available for it. Some of the brands for metolazone might be better known than metolazone itself. If the pharmacy that's willing to deliver medicines to your home doesn't have metolazone in stock, you can ask for one of the branded alternatives for metolazone.