{"id":4195,"date":"2025-03-31T18:12:00","date_gmt":"2025-03-31T18:12:00","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/metolazone-txt\/"},"modified":"2025-03-31T18:12:00","modified_gmt":"2025-03-31T18:12:00","slug":"metolazone-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/metolazone-txt\/","title":{"rendered":"Metolazone.txt"},"content":{"rendered":"

CLINICAL USE <\/H3>
\nThiazide diuretic, acts synergistically with loop diuretics:Oedema Hypertension

DOSE IN NORMAL RENAL FUNCTION <\/H3>Oedema: 5\u201310 mg, increased to 20 mg daily; maximum 80 mg dailyHypertension: 5 mg initially; maintenance: 5 mg on alternate days

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :365.8<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :95<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : 80\u201395<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :1.6<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :8\u201310\/\u2013

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function
  • HDF\/high flux &nbsp :Unknown dialysability. Dose as in normal renal function
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not Dialysed. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Analgesics: increased risk of nephrotoxicity with NSAIDs; antagonism of diuretic effect\n
  • Anti-arrhythmics: hypokalaemia leads to increased cardiac toxicity; effects of lidocaine and mexiletine antagonised\n
  • Antibacterials: avoid administration with lymecycline\n
  • Antidepressants: increased risk of hypokalaemia with reboxetine; enhanced hypotensive effect with MAOIs; increased risk of postural hypotension with tricyclics\n
  • Anti-epileptics: increased risk of hyponatraemia with carbamazepine\n
  • Antifungals: increased risk of hypokalaemia with amphotericinAntihypertensives: enhanced hypotensive effect; increased risk of first dose hypotension with post-synaptic alpha-blockers like prazosin; hypokalaemia increases risk of ventricular arrhythmias with sotalol\n
  • Antipsychotics: hypokalaemia increases risk of ventricular arrhythmias with amisulpride or sertindole; enhanced hypotensive effect with phenothiazines; hypokalaemia increases risk of ventricular arrhythmias with pimozide \u2013 avoid concomitant use\n
  • Atomoxetine: hypokalaemia increases risk of ventricular arrhythmiasCardiac glycosides: increased toxicity if hypokalaemia occurs\n
  • Ciclosporin: increased risk of nephrotoxicity and possibly hypomagnesaemiaLithium excretion reduced, increased toxicity

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>\u2013

    Route <\/H4>Oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>\u2013

    OTHER INFORMATION <\/H4>May result in profound diuresis. Monitor patient\u2019s fluid balance carefullyMonitor for hypokalaemia In patients with creatinine clearance less than 50 mL\/minute there is no clinical evidence of accumulation.
    \n","protected":false},"excerpt":{"rendered":"

    CLINICAL USE Thiazide diuretic, acts synergistically with loop diuretics:Oedema Hypertension<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-4195","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4195","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=4195"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/4195\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=4195"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=4195"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=4195"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}