Metolazone should be used with caution in:
- People with liver problems
- People with kidney problems
- People with heart problems
- People with diabetes
- People with high levels of cholesterol
- People with a history of gout
- the elderly
- People who are malnourished (under-fed)
- People who have hereditary blood disorders called acute porphyrias
- People with a condition called systemic lupus erythematosus that causes inflammation and tissue damage in various parts of the body
- People with a condition called hyperaldosteronism that is due to over-production of aldosterone, a hormone that controls salt and water balance in the body
It should not be used in:
- People who had liver problems which made them lose consciousness (coma) or nearly lose consciousness
- People with allergies to metolazone or other diuretics or to any of the other ingredients in the tablet
- Failure to produce urine (anuria)
- People in whom parathryoid function is being investigated
- Instances when there are low levels of potassium in the blood that can cause muscle weakness, muscle twitching or abnormal heart beat (hypokalaemia)
- Instances when there are high levels of calcium in the blood that can cause loss of appetite, tiredness or muscle weakness (hypercalcaemia)
- Instances when there are low levels of sodium in the blood that can cause tiredness, confusion, muscle twitching, fits or coma (hyponatraemia)
- Instances when there are high levels of uric acid in the blood that is causing symptoms such as gout or kidney stones (hyperuricaemia)
Also see list of precautions and interactions
Store metolazone tablets in their original package away from light.
What is it used for?
- Metolazone is used to treat high blood pressure (hypertension), and fluid retention or swelling (oedema) in the body, which can be due to heart, kidney or liver problems, fluid collection in the stomach (ascites) and eclampsia/pre-eclampsia in pregnancy (high blood pressure and toxins in the blood arising from pregnancy)
- It is a type of diuretic, sometimes known as water tablets.
- It is used to remove excess fluid from the body by increasing your production of urine. The reduction in fluid in your body causes your blood pressure to drop.
Listed below are the typical uses of metolazone:
- High blood pressure (hypertension)
- Fluid retention or swelling (oedema) in the body due to heart, kidney or liver problems
- Fluid collection in the stomach (ascites)
- Eclampsia/pre-eclampsia in pregnancy (high blood pressure and toxins in the blood arising from pregnancy)
HOW TO USE/TAKE
How often do I take it?
- Always take metolazone tablets exactly as your doctor has told you. Swallow the tablets whole with a drink of water.
- Use this medication for the duration of the prescription in order to get the most benefit from it.
- Remember to use it at the same time each day - unless specifically told otherwise by your doctor.
- Certain medical conditions may require different dosage instructions as directed by your doctor.
- Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.
Do I need to avoid anything?
- Alcohol may increase the effects of metalozone in lowering blood pressure, making you feel dizzy and light-headed. If this happens, do not drive or operate machinery. Consult your doctor or pharmacist for more details.
When can I stop?
- Always complete the full course as prescribed by your doctor.
METOLAZONE SIDE EFFECTS
- Loss of appetite
- Being sick
- Upset stomach
- Muscle cramps
- Chest pain
- Gout (painful, red, swollen joints)
- Increased or rapid heart beat
If any of these persist or you consider them severe then inform your doctor or pharmacist.
Tell your doctor immediately if you develop any of the following symptoms:
- Repeated infections with a sore throat and mouth ulcers
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.
Before taking metolazone, tell your doctor or pharmacist if you are allergic to it; or to other diuretics; or if you have any other allergies.
This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have:
- Allergy (hypersensitivity) to metolazone or other diuretics or to any of the other ingredients in the tablet
- Severe liver problems
- Severe kidney problems
- A failure to produce urine (anuria)
- An investigation of parathryoid function being investigated
- Low levels of potassium in your blood that can cause muscle weakness, muscle twitching or abnormal heart beat (hypokalaemia)
- High levels of calcium in your blood that can cause loss of appetite, tiredness or muscle weakness (hypercalcaemia)
- Low levels of sodium in your blood that can cause tiredness, confusion, muscle twitching, fits or coma (hyponatraemia)
- High levels of uric acid in your blood that is causing symptoms, such as gout or kidney stones (hyperuricaemia)
Before using this medication, tell your doctor or pharmacist your medical history, especially any of the following:
- Liver problems
- Kidney problems
- Heart problems
- High cholesterol levels
- A history of gout
- If you are elderly
- If you are malnourished (under-fed)
- If you ahve hereditary blood disorders called acute porphyrias
- A condition called systemic lupus erythematosus that causes inflammation and tissue damage in various parts of the body
- A condition called hyperaldosteronism that is due to over-production of aldosterone, a hormone that controls salt and water balance in the body
- If you are pregnant
- If you are breast-feeding
Before having surgery, tell your doctor or dentist that you are taking this medication.
Does alcohol intake affect this drug?
- Alcohol does not appear to affect this drug.
The elderly: metolazone should be used with caution in the elderly as they are at greater risk of developing low levels of potassium in the blood.
Liver problems. Metolazone should be used with caution in those with liver problems as they are at greater risk of developing low levels of potassium in the blood and a complication of liver disorders that damages the brain and nervous system (hepatic encephalopathy).
Heart problems. Metolazone should be used with caution in those with heart conditions as they are at greater risk of developing an irregularity with their heart beat due to low levels of potassium in the blood. In addition, low levels of potassium increase the toxicity of digoxin, a common heart drug.
Gout. Metolazone should be used with caution in those who tend to get gout as the number of gout attacks may be increased.
Pregnancy and breast-feeding - please ensure you read the detailed information below
There is little evidence of the safety of metolazone in pregnancy, but it has been widely used for many years without any signs of harm. It is therefore sometimes used during in pregnancy.
It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Metolazone passes into breast milk. Seek medical advice from your doctor before using this medicine during breastfeeding.
It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.
If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.
Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:
- Drugs for high blood pressure (hypertension) and heart problems, such as ACE inhibitors (e.g. lisinopril), beta-blockers (e.g. propranolol), calcium channel blockers (e.g. amlodipine), methyldopa, vasodilators (e.g. bosentan)
- Digoxin used to treat heart problems
- Colestyramine used to lower cholesterol
- Warfarin used to thin the blood
- A drug called furosemide that is used to treat heart failure and fluid retention (oedema)
- Drugs for diabetes, such as insulin and metformin
- A type of medicine used for pain relief and inflammation called non-steroid anti-inflammatory drugs (NSAIDs)
- Drugs used to treat allergies and inflammatory diseases called corticosteroids (e.g. prednisolone and betamethasone)
- Drugs used to treat asthma, such as salbutamol and formoterol
- A drug used to treat mental illness called lithium
- A drug used to treat rheumatic disease, skin problems or after a transplant called ciclosporine
If you are currently using any of these medications, tell your doctor or pharmacist before starting metolazone.
This information does not contain all possible interactions. Therefore, before using metolazone tell your doctor or pharmacist of all the products you use.
If you take more metolazone than you should, you may experience thirst, muscle pain or weakness, feel light-headed, faint, slow or shallow breathing and feel or be sick. If this happens, tell your doctor or contact your nearest hospital casualty department immediately.
If you think you, or someone you care for, might have accidentally taken more than the recommended dose of metolazone or intentional overdose is suspected, contact your local hospital, GP or if in England call 111. In Scotland call NHS 24. In Wales, call NHS Direct Wales. In the case of medical emergencies, always dial 999.
If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.