metolazone, Zaroxolyn, Diulo (Discontinued); Mykrox (Discontinued) (cont.)

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DOSING: The recommended dose is 2.5 to 5 mg for hypertension and 2.5-20 mg for treating edema.

DRUG INTERACTIONS: Metolazone can reduce blood potassium and magnesium levels. This is especially true in patients who also are taking "loop" diuretics such as furosemide (Lasix), bumetanide (Bumex), and torsemide (Demadex ). Low potassium and magnesium levels can lead to heart rhythm abnormalities, especially in patients taking digoxin (Lanoxin). Metolazone reduces excretion of lithium (Lithobid, Eskalith) by the kidneys and can lead to lithium toxicity in patients receiving lithium. Steroids (for example, hydrocortisone) and nonsteroidal anti-inflammatory agents (NSAIDs) such as ibuprofen (Motrin), naproxen (Naprosyn), and nabumetone (Relafen) can reduce the effectiveness of metolazone by interfering with the excretion of salt and water.

PREGNANCY: Metolazone should not be used during pregnancy unless absolutely necessary.

NURSING MOTHERS: Metolazone is excreted in breast-milk. Intense diuresis using metolazone may reduce the production of milk. Otherwise metolazone is considered safe to use during nursing if required by the mother.

SIDE EFFECTS: Metolazone generally is well tolerated. Hypokalemia (low blood potassium), hyponatremia (low blood sodium), and hypomagnesemia (low blood magnesium) are common side effects of metolazone. Hypercalcemia (high blood calcium) also may occur.



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