Metolazone

Metolazone is a thiazide related diuretic. Metolazone is a quinazolinone derivative prepared by chemical synthesis. Metolazone is optically active and used as a racemate clinically. Metolazone is given orally. Metolazone is a sulfonamide derivative that has different chemical structure but the possess same pharmacological actions as the thiazide diuretics.

Brands
Adult Dose
Dose: 0.035 to 0.142 mg/kg
Single Dose: 0.088 (0.0885)
Frequency: 24 hourly
Route: PO
Instructions: -
Neonatal
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Paedriatic
Dose:
Single Dose:
Frequency:
Route:
Instructions: Not recommended in this age group
Characteristics
. It is of Synthetic origin and belongs to Sulphonamide. It belongs to NaCl cotransport inhibitor pharmacological group on the basis of mechanism of action and also classified in Diuretic Thiazide pharmacological group.The Molecular Weight of Metolazone is 365.80. Its pKa is 9.72.
Contraindications
Metolazone is contraindicated in conditions like Diabetes mellitus,Ventricular arrhythmias.
Effects
The severe or irreversible adverse effects of Metolazone, which give rise to further complications include Hypokalemia, Hyperglycemia, Hyperglycemia.The symptomatic adverse reactions produced by Metolazone are more or less tolerable and if they become severe, they can be treated symptomatically, these include Headache, Palpitation, Constipation, Chills, Rashes, VertigoX, Muscle cramps, Nocturia, Chest pain.
Indications
Metolazone is primarily indicated in conditions like Congestive heart failure, Edema, Hepatic disease, Hypertension, Oedema, Renal failure.
Interactions
Metolazone is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementBumetanideCaptoprilMetolazone may enhance the hypotensive effect of Captopril. Specifically, postural hypotension which can accompany Captopril initiation. Metolazone may enhance the nephrotoxic effect of Captopril.ModerateMonitor for evidence of significant postural hypotension if Captopril is initiated (first dose) in patient already receiving Metolazone, especially if the patient has signs or symptoms of hypovolemia or hyponatremia. May consider ensuring the patient remains supine for 3 or more hours following the administration of the first dose of the Captopril. Monitor for signs or symptoms of renal dysfunction if these two agents are used concomitantly long-term.Cyclosporin AFrusemide or Furosemide These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Paediatrics, Pregnant Mothers, Cardiac / Hypertensive Patients, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store Below 40°C. Protect from Sunlight and Moisture.
Warnings
Thiazide diuretics increase sensitivity to sunlight, avoid prolonged sun exposure, use a sunscreen and wear protective clothing. This should be used during pregnancy or lactation only if clearly needed. Metolazone should be used with caution in patients with gout or diabetes or any allergy especially to sulfa medications. Avoid any drug that increases heart rate or cause excitation like decongestants (found in cough or cold products) because it may counter-act blood pressure medicine.
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