What is the mechanism of action of metolazone?
Mechanism of Action Metolazone works by inhibiting sodium transport across the epithelium of the renal tubules (mostly in the distal tubules), resulting in a decrease in sodium reabsorption and an increase in sodium, chloride, and water excretion.
Is metolazone licensed in UK?
Metolazone is now only available as an unlicensed special order item in the UK. Metolazone can promote dramatic diuresis and disturbance in fluid balance and electrolytes. Patients must be closely monitored and specialist initiation and advice is required.
What drug class is metolazone?
Metolazone is in a class of medications called diuretics (‘water pills’). It causes the kidneys to reduce the amount of water and salt in the body by increasing the amount of urine.
How long does it take for metolazone to work?
It usually takes 3 to 4 days for metolazone to start reducing edema, and 3 to 6 weeks to start reducing blood pressure.
Does metolazone deplete potassium?
Important warnings Low sodium and potassium levels warning: In rare cases, taking metolazone has suddenly led to low sodium levels (hyponatremia) or low potassium levels (hypokalemia) or both. If this occurs, your doctor may have you stop using metolazone.
Does metolazone cause metabolic alkalosis?
Adverse effects are allergies, alkalosis, hypokalemia, hyperuricemia, hypovolemia, hyperglycemia, hyperlipidemia, hypercalcemia, and sexual dysfunction.
Does metolazone cause hyponatremia?
Metolazone was strongly associated with hyponatremia, hypokalemia, and worsening renal function (P<0.0001 for all) with minimal effect attenuation following covariate and propensity adjustment.
How does metolazone work with furosemide?
Even at low doses metolazone significantly potentiates the diuretic effects of furosemide and therefore simplifies the treatment of fluid retention. High doses of furosemide can be avoided in many cases, a factor of particular advantage in ambulatory long term therapy and in patients with decreased kidney function.
Is metolazone stronger than furosemide?
The mean reduction in body weight was 6.1 kg (2 p less than 0.001) within 7 days of continuous treatment. Even at low doses metolazone significantly potentiates the diuretic effects of furosemide and therefore simplifies the treatment of fluid retention.
How does metolazone affect potassium?
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 ).
What’s the maximum dose of metolazone you can take?
Metolazone was titrated to a maximum dose of 10 mg/day according to the desired response. Ultimately, 12 of the 17 patients diuresed within 72 hours of starting therapy.
How long does it take metolazone to diurese a patient?
Ultimately, 12 of the 17 patients diuresed within 72 hours of starting therapy. Finally, Channer et al. 29 administered either metolazone or bendroflumethiazide to hospitalized CHF patients, in fixed doses of 10 mg each for 3 days, together with intravenous furosemide 80 mg given twice daily.
How to report side effects of metolazone to GP?
Allow at least 48 hours for the community pharmacy to obtain the metolazone as it is an unlicensed medicine. Report any adverse effects, concerns or lack of understanding of the treatment to the GP or specialist. Weigh themselves regularly as requested by clinicians. Ensure they report signs of over diuresis or any signs of worsening symptoms
How is metolazone used to treat CHF patients?
Finally, Channer et al. 29 administered either metolazone or bendroflumethiazide to hospitalized CHF patients, in fixed doses of 10 mg each for 3 days, together with intravenous furosemide 80 mg given twice daily. Both combinations were well tolerated and induced diuresis and weight loss within 24 hours of starting treatment.