Metolazone is used to treat water retention caused by heart failure (weakness and inability of the heart to pump blood) or kidney disease. Water retention may be noticed as swelling of the feet, ankles, lower leg and hands, or shortness of breath. For this reason, it is commonly known as a "water pill".
This medicine is also used on its own or together with other medicines to help keep your blood pressure under control.
Take Metolazone exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
You may need to pass urine more often while being treated with Metolazone. Take this medicine early in the day, preferably in the morning, to prevent you from frequently waking up at night to go to the toilet.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the course of your treatment depending on the type and severity of your condition and your response to the medication.
Metolazone must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you are unable to pass urine as Metolazone may not be suitable for you.
This medicine may also not be suitable for individuals who are in a coma or comatose condition which is caused by liver disease.
Inform your doctor if you have the following conditions:
- diabetes
- systemic lupus erythematosus or SLE (autoimmune disease that causes inflammation of certain organs in the body)
- gout (high uric acid level in the blood)
- allergy to medicines that contain sulfonamide
- electrolyte imbalance (imbalance of essential minerals in the body)
- Addison's disease (a rare disorder where the adrenal glands produce insufficient amounts of certain hormones)
- severe kidney disease
- severe liver disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Metolazone to the elderly. Elderly people may be more sensitive to the side effects.
Do not switch between different brands unless instructed by your doctor. This is because different brands of Metolazone may have slightly different ways of working in your body.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. kidney function, uric acid and electrolyte levels) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have these tests.
- Your blood pressure may fall to unsafe levels without you noticing it. Monitor your blood pressure regularly during treatment.
- Regular monitoring of signs of electrolyte imbalance, allergic reactions or low blood pressure may also be needed.
What lifestyle changes can I make to improve my blood pressure?
Regular exercise and eating a healthy diet will help control your blood pressure and improve your overall health. Engage in physical activity like walking for at least 30 to 60 minutes on most days of the week. If you have not exercised for a long time, start with light exercises such as slow walks. Speak to your doctor about what type of exercise would be suitable for you. Follow a healthy diet plan by eating more fruits, vegetables, whole grains and low-fat dairy products and reduce your intake of foods high in saturated fat, cholesterol and sodium. Cutting down on deep-fried foods and using less salt when cooking can kick-start your healthy diet.
If you smoke, you should try to quit. Smoking is harmful to your blood pressure, heart and overall health. Speak to your doctor or pharmacist about ways to stop your smoking habit.
Metolazone may cause any of the following side effects: headache, dizziness with or without sensations of spinning, drowsiness, blurred vision, nausea, diarrhoea, vomiting, chills, stomach pain, bloating, loss of appetite, and muscle or joint pain.
This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.
You may need to pass urine more often while you are being treated with this medicine. As your body adjusts to the medicine, this urination effect should also decrease.
Metolazone may also make your skin more sensitive to sunlight. Apply sunscreen when going outdoors and avoid prolonged exposure to sunlight and UV lamps.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swelling of the face, eyes, mouth or throat
- muscle weakness, cramping or numbness; fast or irregular heartbeat, dry mouth, dry eyes, increased thirst, severe dizziness or passing out, severe nausea and vomiting, feeling very weak or tired
- frequent sore throat, fever, chills or sweating; unusual bleeding or bruising
- rashes with peeling of the skin or blistering of the lips, mouth or eyes accompanied by fever
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- other water pills or medicines for water retention e.g. furosemide
- corticosteroids (anti-inflammatory medicines) e.g. prednisolone
- medicines for high blood pressure e.g. captopril
- NSAIDs (medicines for pain and inflammation) e.g. ibuprofen, naproxen, celecoxib
- medicines for diabetes
- lithium (medicine for mood disorder)
- methenamine (certain antibiotic)
- digoxin (medicine for heart failure)
- cislosporin (medicine used in organ transplants or certain immune disorders)
- allopurinol (medicine for gout)
This list does not include all medicines that may interact with Metolazone.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements, and medicines that you buy without a prescription.
Avoid alcohol. Alcohol intake may worsen the dizziness caused by Metolazone.
Cut down on your salt intake. This may help lower your blood pressure and improve your overall health. Discuss with your doctor or dietitian about ways to cut down on your salt intake.
Store in a cool, dry place away from the reach of children.
Protect from light.
Medicines must not be used past the expiry date.
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