Precautions and Warnings With Metolazone

Being aware of precautions and warnings with metolazone can help minimize risks and ensure a safe treatment process. People who should not take the drug include those who have severe liver disease, are not producing any urine, or are allergic to any ingredient used to make metolazone. Precautions and warnings also apply to women who may be pregnant or are breastfeeding.

Metolazone: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking metolazone (Zaroxolyn®) if you have:
  • Liver disease, including liver failure or cirrhosis
  • Kidney disease or kidney failure
  • Diabetes
  • Systemic lupus erythematosus (lupus or SLE)
  • Gout
  • Fluid or electrolyte problems
  • Any allergies, including allergies to sulfa drugs, foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Tell your healthcare provider about any other medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Precautions and Warnings With Metolazone

Warnings and precautions to be aware of prior to taking metolazone include the following:
  • The medication may affect electrolytes in the blood (especially sodium and potassium). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider. These symptoms may include:
    • Dry mouth
    • Thirst
    • Weakness
    • Lethargy
    • Drowsiness
    • Restlessness
    • Muscle pain or muscle cramps
    • Low blood pressure (hypotension)
    • Decreased urination
    • A rapid heart rate (tachycardia) or an irregular heart rhythm (arrhythmia)
    • Nausea or vomiting.
  • If kidney problems seem to be getting worse (especially for those who have severe kidney disease), metolazone should be stopped, as the medication can make kidney problems worse.
  • There are a number of medicines that can interact with metolazone (see Drug Interactions With Metolazone).
  • The medication can also make gout worse.
  • If you are allergic to sulfonamide ("sulfa" drugs), you may also be allergic to metolazone.
  • Metolazone may cause extremely low blood pressure in some people. This is more likely to happen when the medicine is first started or the dosage is changed. It is also more likely to happen in people who are on dialysis, who have congestive heart failure, who have diarrhea or vomiting, or who have excessive sweating. This is why it is important to drink fluids regularly while taking the drug. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting spells, contact your healthcare provider. If you have fainted, stop taking metolazone until you have talked to your healthcare provider.
  • Do not drive, operate any heavy machinery, or perform any other tasks that require alertness until you know how metolazone affects you.
  • The medication may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, may even cause diabetes in people without a history of the condition.
  • Metolazone can cause systemic lupus erythematosus (lupus or SLE) or make lupus worse.
  • Metolazone is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are not known. Talk to your healthcare provider about the risks and benefits of using the drug when pregnant (see Metolazone and Pregnancy).
  • Metolazone does pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Metolazone and Breastfeeding).
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Metolazone Drug Information

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