Metolazone

Metolazone is a diuretic with actions and uses similar to those of the thiazide diuretics even though it does not contain a thiazide ring system.

Indications

Oedema, including that associated with heart failure and for hypertension.

Dosage

Oedema usual dose is 5 to 10mg, in some cases doses of 20mg or more but nor more than 80mg to be given in 24 hrs. Hypertension:- 2.5 to 5mg daily either alone or with other antihypertensives.

Contra-Indications

Hypersensitivity to metolazone, other thiazides and sulfonamide derivatives, anuria, hepatic coma, severe renal and hepatic dysfunction, refractory hypokalaemia, hyponatraemia, hypercalcaemia, symptomatic hyperuricaemia, Addison's disease. Pregnany.

Special Precautions

Diabetes mellitus; gout; electrolyte disturbances; lupus erythematosus; hepatic and renal impairment; elderly; porphyria, Lactation.

Side Effects

Postural hypotension, palpitations, chest pain, chills; hypokalaemia, hypomagnesaemia, hyponatraemia, hypochloraemic alkalosis, hypercalcaemia, hyperglycaemia, hyperuricaemia, hyperglycaemia, impotence, mild GI effecs, blood disorders; pancreatitis, hypersensitivity reactions; gout; altered plasma concentration; rashes;photosensitivity; intraheptic cholestasis.

Drug Interactions

Furosemide, ACE inhibitors, glibendamide.