Metolazone

Metolazone is a prescription drug and is a “water pill” (diuretic) that increases the amount of urine you make, which causes your body to get rid of excess water. This drug is used to treat high blood pressure. Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.

Metolazone also reduces swelling/fluid retention (edema) which can result from conditions such as congestive heart failure or kidney disease. This can help to improve symptoms such as trouble breathing.

Metolazone is available under the following different brand names: Zaroxolyn.

Dosages of Metolazone:

Adult and pediatric dosages:

• 2.5 mg (geriatric only)
• 5 mg
• 10 mg

Dosage Considerations – Should be Given as Follows:

Hypertension

• 2.5-5 mg orally once daily; may be increased to 20 mg once daily as needed

Edema in Adults

• 2.5-10 mg orally once daily initially; may be gradually increased to 20 mg once daily

Geriatric

• 2.5 mg orally once daily or every other day

Pediatric (off-label)

• 0.2-0.4 mg/kg/day orally in single dose or divided every 12 hours

Dosing Modifications

• Renal impairment: not necessary to supplement dose in hemodialysis or peritoneal dialysis

Dosing Considerations

Geriatric

• Increased risk of azotemia and electrolyte depletion when used in combination with diuretics in elderly

Overdose Management

• Normal saline may be used for volume replacement
• Dopamine or norepinephrine may be used to treat low blood pressure
• Discontinue treatment if no symptoms are apparent for 6 hours