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Metolazone is a diurectic 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 10 mg. in some cases doses of 20 mg or more but nor more than 80 mg to be given in 24 hrs.
Hypertension: 2.5 to 5 mg daily either alone or with other antihypertensives.
CONTRAINDICATIONS: Hypersensitivity to metolazone, other thiazides and sulfonamide derivatives, anuria, hepatic coma, severe renal and hepatic dysfunction, refractory hypokalaemia, hyponatraemia, hypercalcaemia, symptomatic hyperuricaemia, Addison's dieases. Pregnancy.
DRUG INTERACTIONS: Furosemide, ACE inhibitors, glibendamide.
Precautions: Diabetes mellitus; gout; electrolyte disturbances; lupus erythematosus; hepatic and renal impairment; elderly; porphyria, Lactation.
ADVERSE REACTIONS: Postural hypotension, palpitations, chest pain, chills; hypocalcaemia, hypomagnesaemia, hyponatraemia, hypochloraemic alkalosis, hypocalcaemia, hyperglycaemia, hyperuricaemia, hyperglycaema, impotence, mild GI effaces, blood disorders; pancreatitis, hypersensitivity reactions; gout; altered plasma concentration; rashes; photosensitivity; intraheptic cholestasis.