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Metolazone - Pharmacology: Increases urinary excretion of sodium and chloride by inhibiting reabsorption in ascending limb of loop of Henle and early distal tubules.

Indication: For the treatment of hypertension, alone or in combination with other antihypertensive drugs of a different class; for the treatment of salt and water retention, including the following: edema accompanying CHF; edema accompanying renal diseases, including the nephrotic syndrome and states of diminished renal function.

Unlabeled Uses

Diabetes insipidus; osteoporosis.

Metolazone is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Metolazone treats fluid retention (edema) in people with congestive heart failure, or a kidney disorder such as nephrotic syndrome. This medication is also used to treat high blood pressure (hypertension).

Metolazone may also be used for other purposes not listed in this medication guide.

Metolazone is a quinazoline diuretic, with properties generally similar to the thiazide diuretics. A proximal action of Metolazone has been shown in humans by increased excretion of phosphate and magnesium ions and by a markedly increased fractional excretion of sodium in patients with severely compromised glomerular filtration. This action has been demonstrated in animals by micropuncture studies.

Metolazone helps to keep your blood pressure under control. Metolazone is also used to treat water retention caused by heart, liver or kidney disease. Water retention may be noticed as swelling of the feet, ankles, lower leg and hands. For this reason, it is commonly known as a "water pill". Metolazone may also be used to treat other medical conditions, as decided by your doctor.

Oral Hypertension

Adult: Initially, 1.25 mg daily, adjusted after 3-4 wk according to response. Usual dose: 2.5-5 mg daily, either alone or with other antihypertensives. Maintenance dose: 5 mg on alternate days. Formulations with enhanced bioavailability: 0.5-1 mg daily.

Elderly: Initially, 2.5 mg/day or every other day. Oral Oedema

Adult: 5-10 mg daily, increased if necessary to 20 mg daily. Max: 80 mg in 24 hr.

Elderly: Initially, 2.5 mg/day or every other day.


Adult: PO HTN Initial:1.25 mg/day, adjusted after 3-4 wk. Usual range: 2.5-5 mg/day, either alone or w/ other antihypertensives.

Maintenance: 5 mg on alternate days. Oedema 5-10 mg/day, up to 20 mg/day if needed. Max: 80 mg/24 hr.