Metolazone is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Metolazone is used to treat fluid retention (edema) in people with congestive heart failure, or a kidney disorder such as nephrotic syndrome. Metolazone is also used to treat high blood pressure (hypertension).

Metolazone may also be used for purposes not listed in this medication guide.

You should not use metolazone if you are unable to urinate, or if you have severe liver disease.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Metolazone is usually taken only once per day.

You may need to limit salt in your diet while taking this medicine. Follow your doctor's instructions carefully.

While using metolazone, you may need frequent blood tests. Your blood and urine may both be tested if you have been vomiting or are dehydrated.

Metolazone can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using metolazone.

If you need surgery, tell the surgeon ahead of time that you are using metolazone. You may need to stop using the medicine for a short time.

If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.

Store the tablets at room temperature away from heat, light, and moisture.

Usual Adult Dose for Hypertension:

Initial dose: 2.5 mg orally once a day (Zaroxolyn) or
0.5 mg orally once a day (Mykrox).

Usual Adult Dose for Edema:

Initial dose: 5 mg orally once a day (Zaroxolyn) or
0.5 mg orally once a day (Mykrox).

You should not use metolazone if you are allergic to it, or if you have:

• severe liver disease; or

• if you are unable to urinate.

To make sure metolazone is safe for you, tell your doctor if you have:

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

• a heart rhythm disorder;

• an allergy to sulfa drugs;

• liver disease;

• kidney disease;

• diabetes;

• gout; or

• systemic lupus erythematosus.

Using metolazone during pregnancy could cause side effects in the newborn baby, such as blood cell problems, or jaundice (yellowing of the skin or eyes). Tell your doctor if you are pregnant or if you become pregnant while using metolazone.

Metolazone can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Metolazone is not approved for use by anyone younger than 18 years old.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include severe dizziness or drowsiness, dry mouth, thirst, muscle weakness, feeling light-headed, or fainting.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Follow your doctor's directions. they may include a daily exercise program and a low-sodium or low-salt diet, potassium supplements, and increased amounts of potassium-rich foods (e.g., bananas, prunes, raisins, and orange juice) in your diet.

Drinking alcohol with metolazone can cause side effects.

Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Metolazone may cause serious side effects. Call your doctor at once if you have:

• chest pain;

• pounding heartbeats or fluttering in your chest;

• easy bruising or bleeding;

• a light-headed feeling, like you might pass out;

• liver problems--nausea, upper stomach pain, itching, tiredness, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);

• low potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling;

• low levels of sodium in the body--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;

• other signs of an electrolyte imbalance--dry mouth, nausea, vomiting, weakness, drowsiness, lack of energy, muscle pain, little or no urination, or feeling restless; or

• severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects of metolazone may include:

• dizziness, spinning sensation;

• drowsiness, tiredness;

• depressed mood;

• muscle or joint pain;

• numbness or tingly feeling;

• nausea, stomach pain, loss of appetite; or

• diarrhea, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Taking this medicine with other drugs that make you make you light-headed can worsen this effect. Ask your doctor before taking metolazone with a narcotic pain medicine, muscle relaxer, or medicine for anxiety or seizures.

Tell your doctor about all your current medicines and any you start or stop using, especially:

• any other blood pressure medication;

• digoxin, digitalis;

• furosemide or other diuretics (water pills);

• insulin or oral diabetes medicine;

• lithium;

• methenamine;

• vitamin D (at high doses);

• a blood thinner--warfarin, Coumadin, Jantoven;

• NSAIDs (nonsteroidal anti-inflammatory drugs)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;

• salicylates--aspirin, Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others; or

• steroid medicine--prednisone and others.

This list is not complete. Other drugs may interact with metolazone, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to metolazone.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking metolazone.

Learn the brand name of your medication. Do not switch brands without talking to your doctor or pharmacist, as different brands of metolazone may work differently in the body.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.