metolazone

(me TOE la zone)
Mykrox, Zaroxolyn

What is the most important information I should know about metolazone?

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To reduce nighttime urination, take metolazone early in the day unless otherwise directed by your doctor.

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Do not change the brand or generic formulation of metolazone that you are taking without first talking to your doctor.

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Use caution when driving, operating machinery, or performing other hazardous activities. Metolazone may cause dizziness. If you experience dizziness, avoid these activities.

What is metolazone?

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Metolazone is a thiazide diuretic (water pill). It decreases the amount of fluid in the body by increasing the amount of salt and water lost in the urine.

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Metolazone is used to lower blood pressure and to decrease edema (swelling).

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Metolazone may also be used for purposes other than those listed in this medication guide.

What should I discuss with my healthcare provider before taking metolazone?

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Do not take metolazone without first talking to your doctor if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to metolazone.

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Before taking metolazone, tell your doctor if you have

diabetes,

gout,

a collagen vascular disease such as systemic lupus erythematosus,

pancreatitis,

kidney disease,

liver disease, or

high levels of cholesterol or triglycerides (types of fat) in your blood.

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You may need a dosage adjustment or special monitoring during therapy if you have any of the conditions listed above.

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Metolazone is in the FDA pregnancy category B. This means that it is not expected to be harmful to an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant.

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Metolazone passes into breast milk and may affect a nursing infant. Do not take metolazone without first talking to your doctor if you are breast-feeding a baby.

How should I take metolazone?

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Take metolazone exactly as directed by your doctor. If you do not understand these instructions, ask your pharmacist, nurse, or doctor to explain them to you.

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Take each dose with a full glass of water.

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To reduce nighttime urination, take metolazone early in the day unless otherwise directed by your doctor.

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It is important to take metolazone regularly to get the most benefit.

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Do not stop taking metolazone suddenly even if you feel better. Stopping suddenly could make your condition worse.

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Do not change the brand or generic formulation of metolazone that you are taking without first talking to your doctor.

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Store this medication at room temperature away from moisture and heat.

What happens if I miss a dose?

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Take the missed dose as soon as you remember. However, if it is almost time for the next dose however, skip the dose you missed and take only the next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

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Seek emergency medical attention if an overdose is suspected.

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Symptoms of a metolazone overdose include increased urination, nausea, vomiting, diarrhea, fatigue, lethargy, and unconsciousness.

What should I avoid while taking metolazone?

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Use caution when driving, operating machinery, or performing other hazardous activities. Metolazone may cause dizziness. If you experience dizziness, avoid these activities.

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Use alcohol cautiously. Alcohol may increase the side effects of metolazone.

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Avoid a diet high in salt. Too much salt may cause the body to retain water and may decrease the effects of metolazone.

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Avoid prolonged exposure to sunlight. Metolazone may increase the sensitivity of the skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

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Avoid becoming overheated in hot weather and during exercise. It is easier to become dangerously dehydrated while taking metolazone.

What are the possible side effects of metolazone?

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If you experience any of the following serious side effects, stop taking metolazone and seek emergency medical attention or contact your doctor immediately:

an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

unusual fatigue;

abnormal bleeding or bruising;

yellow skin or eyes;

confusion;

irregular heartbeats or a fluttering feeling in the chest; or

little or no urine.

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Other, less serious side effects are more likely to occur. Continue to take metolazone and talk to your doctor if you experience

dizziness, especially when you switch to sitting or standing from a lying position;

tingling or numbness in the arms, legs, hands, or feet;

excessive urination;

muscle weakness or cramps;

increased hunger or thirst;

nausea or decreased appetite;

abdominal pain;

sensitivity to sunlight; or

impotence.

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Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect metolazone?

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Before taking metolazone tell your doctor if you are taking any of the following medications:

lithium (Lithobid, Eskalith, others);

digoxin (Lanoxin, Lanoxicaps);

the cholesterol-lowering drugs cholestyramine (Questran) or colestipol (Colestid);

a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Motrin, Advil, Nuprin), naproxen (Naprosyn, Anaprox, Aleve), ketoprofen (Orudis, Orudis KT, Oruvail), indomethacin (Indocin), diclofenac (Cataflam, Voltaren), etodolac (Lodine), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), tolmetin (Tolectin), fenoprofen (Nalfon), ketorolac (Toradol), or flurbiprofen (Ansaid);

a diabetes medication such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), tolbutamide (Orinase), and others; or

a steroid medicine such as cortisone (Cortone), dexamethasone (Decadron, Hexadrol), hydrocortisone (Cortef, Hydrocortone), prednisone (Orasone, Deltasone), prednisolone (Delta Cortef, Prelone), methylprednisolone (Medrol), and others.

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You may not be able to take metolazone, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medications listed above.

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Also, before taking a metolazone, tell your doctor if you are taking any other medicine to treat high blood pressure, water retention, heart problems, prostate problems, or another condition. Some medicines used to treat these conditions may interact with metolazone and the effects on your heart may be increased.

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Metolazone may increase the effects of other drugs that cause drowsiness, including sedatives (used to treat insomnia), pain relievers, seizure medicines, antidepressants, alcohol, antihistamines, anxiety medicines, and muscle relaxants. Tell your doctor about all medicines that you are taking, and do not take any medicine without first talking to your doctor.

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Drugs other than those listed here may also interact with metolazone or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

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Your pharmacist has additional information about metolazone written for health professionals that you may read.

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Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.