Metolazone Brand Names- Mykrox | Zaroxolyn
What is Metolazone
Metolazone is an oral quinazoline diuretic used for the management of edema and hypertension.
Although it is not a true thiazide, metolazone is a sulfonamide derivative like the thiazides, and its site of action is similar.
However, unlike thiazide diuretics, metolazone may produce diuresis in patients with impaired renal function.
Zaroxolyn® is a tablet formulation of metolazone with relatively slow and incomplete absorption.
A more rapidly absorbed tablet formulation with more complete bioavailability,
Mykrox®, is no longer available in the US.
Metolazone was approved by the FDA in 1973.
A generic version of Zaroxolyn® was approved on December 19, 2003.
Indications
- edema
- heart failure
- hypertension
- nephrotic syndrome
Side Effects
- abdominal pain
- agranulocytosis
- anaphylactoid reactions
- anorexia
- anxiety
- aplastic anemia
- arthralgia
- asthenia
- azotemia
- blurred vision
- chest pain (unspecified)
- constipation
- depression
- diarrhea
- drowsiness
- dysgeusia
- dyspepsia
- elevated hepatic enzymes
- exfoliative dermatitis
- glycosuria
- gout
- hepatitis
- hypercalcemia
- hypercholesterolemia
- hyperglycemia
- hypertriglyceridemia
- hyperuricemia
- hypochloremia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypophosphatemia
- hypovolemia
- impotence (erectile dysfunction)
- insomnia
- jaundice
- leukopenia
- metabolic alkalosis
- muscle cramps
- myalgia
- nausea
- orthostatic hypotension
- palpitations
- pancreatitis
- paresthesias
- petechiae
- photosensitivity
- polyuria
- pruritus
- purpura
- rash
- restlessness
- sialadenitis
- Stevens-Johnson syndrome
- syncope
- thrombocytopenia
- thrombosis
- toxic epidermal necrolysis
- urticaria
- vasculitis
- vertigo
- visual impairment
- vomiting
- xerostomia
Monitoring Parameters
- blood glucose
- serum calcium
- serum cholesterol profile
- serum creatinine/BUN
- serum electrolytes
- serum magnesium
- serum uric acid
Contraindications
- anuria
- breast-feeding
- coma
- diabetes mellitus
- electrolyte imbalance
- geriatric
- gout
- hepatic disease
- hepatic encephalopathy
- hypercalcemia
- hyperglycemia
- hyperuricemia
- hypochloremia
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypotension
- hypovolemia
- jaundice
- metabolic alkalosis
- neonates
- orthostatic hypotension
- pancreatitis
- pregnancy
- renal disease
- renal failure
- renal impairment
- sulfonamide hypersensitivity
- sunlight (UV) exposure
- sympathectomy
- syncope
- systemic lupus erythematosus (SLE)
Interactions
- Acarbose
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Dichloralphenazone; Isometheptene
- Acetaminophen; Guaifenesin; Phenylephrine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Pseudoephedrine
- Acetaminophen; Tramadol
- Acetazolamide
- Acetohexamide
- Aclidinium; Formoterol
- Acrivastine; Pseudoephedrine
- Albiglutide
- Albuterol
- Albuterol; Ipratropium
- Aldesleukin, IL-2
- Alemtuzumab
- Alendronate; Cholecalciferol
- Alfentanil
- Allopurinol
- Alogliptin
- Alogliptin; Metformin
- Alogliptin; Pioglitazone
- Alpha-glucosidase Inhibitors
- Alprostadil
- Amifostine
- Aminolevulinic Acid
- Amiodarone
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine; Dextroamphetamine Salts
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Amyl Nitrite
- Angiotensin-converting enzyme inhibitors
- Anticholinergics
- Apomorphine
- Apraclonidine
- Arformoterol
- Aripiprazole
- Arsenic Trioxide
- Articaine; Epinephrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Omeprazole
- Aspirin, ASA; Oxycodone
- Atracurium
- Atropine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Edrophonium
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Baclofen
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benazepril
- Benazepril; Hydrochlorothiazide, HCTZ
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Benztropine
- Beta-agonists
- Bortezomib
- Bosentan
- Brexpiprazole
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Budesonide; Formoterol
- Buprenorphine
- Buprenorphine; Naloxone
- Cabergoline
- Calcium
- Calcium Phosphate, Supersaturated
- Calcium; Vitamin D
- Canagliflozin
- Canagliflozin; Metformin
- Captopril
- Captopril; Hydrochlorothiazide, HCTZ
- Carbamazepine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbidopa; Levodopa
- Carbidopa; Levodopa; Entacapone
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cardiac glycosides
- Cariprazine
- Celecoxib
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlophedianol; Guaifenesin; Phenylephrine
- Chlordiazepoxide; Clidinium
- Chloroprocaine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpropamide
- Cholestyramine
- Cidofovir
- Cisapride
- Cisatracurium
- Citalopram
- Clindamycin; Tretinoin
- Clozapine
- Co-Enzyme Q10, Ubiquinone
- Cocaine
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine; Probenecid
- Colestipol
- Conivaptan
- Corticosteroids
- Cosyntropin
- Cyclophosphamide
- Dapagliflozin
- Dapagliflozin; Metformin
- Dapagliflozin; Saxagliptin
- Desloratadine; Pseudoephedrine
- Desvenlafaxine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexlansoprazole
- Dexmethylphenidate
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Quinidine
- Diazoxide
- Dichlorphenamide
- Diclofenac
- Diclofenac; Misoprostol
- Dicyclomine
- Diethylpropion
- Diflunisal
- Digitoxin
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dobutamine
- Dofetilide
- Dolasetron
- Dopamine
- Doxacurium
- Droperidol
- Dulaglutide
- Duloxetine
- Empagliflozin
- Empagliflozin; Linagliptin
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Enalapril, Enalaprilat
- Enalapril; Felodipine
- Enalapril; Hydrochlorothiazide, HCTZ
- Enflurane
- Ephedrine
- Epinephrine
- Ergocalciferol, Vitamin D2
- Ertugliflozin; Metformin
- Ertugliflozin; Sitagliptin
- Escitalopram
- Esomeprazole
- Esomeprazole; Naproxen
- Estradiol
- Estradiol Cypionate; Medroxyprogesterone
- Ethanol
- Etodolac
- Etomidate
- Exenatide
- Famotidine; Ibuprofen
- Fenoprofen
- Fentanyl
- Fexofenadine; Pseudoephedrine
- Fish Oil, Omega-3 Fatty Acids (Dietary Supplements)
- Flavoxate
- Fluocinolone; Hydroquinone; Tretinoin
- Fluoxetine
- Fluoxetine; Olanzapine
- Flurbiprofen
- Fluticasone; Salmeterol
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Formoterol
- Formoterol; Mometasone
- Fosinopril
- Fosinopril; Hydrochlorothiazide, HCTZ
- Fospropofol
- Gallium Ga 68 Dotatate
- General anesthetics
- Glimepiride
- Glimepiride; Pioglitazone
- Glimepiride; Rosiglitazone
- Glipizide
- Glipizide; Metformin
- Glyburide
- Glyburide; Metformin
- Glycopyrrolate
- Glycopyrrolate; Formoterol
- Granisetron
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guaifenesin; Phenylephrine
- Guaifenesin; Pseudoephedrine
- Halobetasol; Tazarotene
- Halofantrine
- Haloperidol
- Halothane
- Homatropine; Hydrocodone
- Hydralazine; Isosorbide Dinitrate, ISDN
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hyoscyamine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen
- Ibuprofen lysine
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Icosapent ethyl
- Iloperidone
- Inamrinone
- Incretin Mimetics
- Indacaterol
- Indacaterol; Glycopyrrolate
- Indomethacin
- Inotersen
- Insulin Degludec; Liraglutide
- Insulin Glargine; Lixisenatide
- Insulins
- Intravenous Lipid Emulsions
- Isocarboxazid
- Isoflurane
- Isoproterenol
- Isosorbide Dinitrate, ISDN
- Isosorbide Mononitrate
- Ketamine
- Ketoprofen
- Ketorolac
- Lansoprazole
- Lansoprazole; Naproxen
- Lesinurad; Allopurinol
- Levalbuterol
- Levodopa
- Levomethadyl
- Levomilnacipran
- Levorphanol
- Linagliptin
- Linagliptin; Metformin
- Liraglutide
- Lisdexamfetamine
- Lisinopril
- Lithium
- Lixisenatide
- Loop diuretics
- Loratadine; Pseudoephedrine
- Lovastatin; Niacin
- Lurasidone
- Magnesium Salts
- Magnesium Sulfate; Potassium Sulfate; Sodium Sulfate
- Mannitol
- Meclofenamate Sodium
- Mefenamic Acid
- Meglitinides
- Meloxicam
- Mepenzolate
- Meperidine
- Meperidine; Promethazine
- Mequinol; Tretinoin
- Mestranol; Norethindrone
- Metaproterenol
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methadone
- Methamphetamine
- Methazolamide
- Methenamine
- Methenamine; Sodium Acid Phosphate
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methotrexate
- Methoxsalen
- Methscopolamine
- Methylphenidate
- Metoclopramide
- Midodrine
- Miglitol
- Milnacipran
- Milrinone
- Mirtazapine
- Mivacurium
- Moexipril
- Morphine
- Morphine; Naltrexone
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nateglinide
- Nefazodone
- Nesiritide, BNP
- Neuromuscular blockers
- Niacin, Niacinamide
- Niacin; Simvastatin
- Nitrates
- Nitroglycerin
- Nitroprusside
- Nonsteroidal antiinflammatory drugs
- Norepinephrine
- Octreotide
- Olanzapine
- Olodaterol
- Omeprazole
- Omeprazole; Amoxicillin; Rifabutin
- Omeprazole; Sodium Bicarbonate
- Ondansetron
- Oprelvekin, rh-IL-11
- Oxaprozin
- Oxybutynin
- Oxycodone
- Oxymetazoline
- Oxymorphone
- Paliperidone
- Pancuronium
- Pantoprazole
- Paroxetine
- Pasireotide
- Pentamidine
- Pentazocine
- Pentazocine; Naloxone
- Pentoxifylline
- Perindopril
- Perindopril; Amlodipine
- Phendimetrazine
- Phenelzine
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine
- Phenylephrine; Promethazine
- Photosensitizing agents (topical)
- Pimozide
- Pioglitazone
- Pirbuterol
- Piroxicam
- Polycarbophil
- Polyethylene Glycol; Electrolytes
- Polyethylene Glycol; Electrolytes; Ascorbic Acid
- Porfimer
- Pramlintide
- Prazosin
- Prilocaine; Epinephrine
- Probenecid
- Procainamide
- Procaine
- Propantheline
- Propofol
- Pseudoephedrine
- Quetiapine
- Quinapril
- Quinidine
- Rabeprazole
- Ramipril
- Rapacuronium
- Rasagiline
- Remifentanil
- Repaglinide
- Risperidone
- Ritodrine
- Rocuronium
- Rofecoxib
- Rosiglitazone
- Salicylates
- Salmeterol
- Saxagliptin
- Scopolamine
- Semaglutide
- Serotonin norepinephrine reuptake inhibitors
- Sertraline
- Sevoflurane
- Silodosin
- Simvastatin; Sitagliptin
- Sitagliptin
- Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
- Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
- Solifenacin
- Streptozocin
- Succinylcholine
- Sufentanil
- Sulfacetamide
- Sulfacetamide; Sulfur
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulfinpyrazone
- Sulfonylureas
- Sulindac
- Tapentadol
- Tazarotene
- Tegaserod
- Terbutaline
- Tetrabenazine
- Tetracaine
- Thiazolidinediones
- Thiothixene
- Tiotropium; Olodaterol
- Tizanidine
- Tolazamide
- Tolbutamide
- Tolmetin
- Tolterodine
- Tolvaptan
- Toremifene
- Tramadol
- Trandolapril
- Trandolapril; Verapamil
- Tranylcypromine
- Trazodone
- Treprostinil
- Tretinoin, ATRA
- Trihexyphenidyl
- Trospium
- Tubocurarine
- Umeclidinium; Vilanterol
- Valdecoxib
- Vecuronium
- Venlafaxine
- Verteporfin
- Vilazodone
- Vitamin D
- Vitamin D analogs
- Vorinostat
- Vortioxetine
- Yohimbine
- Ziconotide
- Ziprasidone
