This medicine contains as active ingredient metolazone, a thiazide-like diuretic. Thiazide diuretics increase urine production by affecting the movement of sodium and chloride in the kidney. They reduce sodium, magnesium, bicarbonate, chloride, and potassium levels and they also raise blood sugar. These drugs are used in the treatment of any disease where it is desirable to eliminate large quantities of water.

These diuretics begin to work within 2 hours and produce their effect in 2- 6 hours. The differences between thiazide diuretic drugs lie in the duration of the effect – 6-12 hours for some and as long as 48-72 hours for others.

Prescribed for

Thiazide or thiazide-like diuretics are prescribed to treat high blood pressure (hypertension). They are also used to reduce fluid accumulation in the body caused by conditions such as heart failure, cirrhosis, kidney disease, and the long-term use of some medications. Thiazide  diuretics may also be used for other conditions as determined by your doctor.

Prescribed for:

•   Hypertension

•   Edema associated with congestive heart failure

•   Cirrhosis of the liver

•   Kidney malfunction

Cautions and Warnings

If you have a history of allergy or bronchial asthma, you may also have a sensitivity or allergy to thiazide diuretics.

Thiazides may raise total cholesterol, LDL-cholesterol, and total triglyceride levels. They should be used with caution by people with moderate to high blood-cholesterol or triglyceride  levels.

People with diabetes may experience increased blood-sugar levels and will need dosage adjustments of their antidiabetic medication.

Before using this medicine

Before you use this medicine check with your doctor, or  pharmacist:

•    if you ever had any unusual or allergic reaction to sulfonamides (sulfa drugs) or any of the thiazide diuretics

•    if you are on a low-salt, low-sugar, or any other special diet, or if you are allergic to any substance, such as sulfites or other preservatives or dyes

•    if you are pregnant or intend to become pregnant while using this medicine. When this medicine is used during pregnancy, it may cause side effects including jaundice, blood problems, and low potassium in the newborn

•    if you are breast-feeding an infant. Although this medicine has not been shown to cause problems in humans, the chance always exists since thiazide diuretics pass into breast milk

•   if you have any of the following medical problems:

•   Diabetes

•   Gout

•   Kidney disease

•   Liver disease

•   Lupus erythematosus

•   Pancreas disease


Usual dosage

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change or stop taking your medication without your doctor’s approval. Adult: dosis is individualized; 0.5-20 mg once a day, depending on formulation.

Thiazide diuretics may cause an unusual feeling of tiredness when you begin to take them. You may also notice an increase in urine or in frequency of urination. To keep this from affecting sleep:

If you are to take a single dose a day, take it in the morning after breakfast; if you are to take more than one dose, take the last one not later than 6 p.m.

Side effects

Along with the needed effects, a medicine may cause some unwanted effects. Side effects that usually do not require medical attention: decreased sexual ability; dizziness or lightheadedness when standing up; increased sensitivity of skin to sunlight; loss of appetite; upset stomach.

Side effects that should be reported to your doctor: black, tarry stools; blood in urine or stools; cough or hoarseness; fever or chills; joint pain; lower back or side pains; painful or difficult urination; pinpoint red spots on skin; skin rash or hives; stomach pain (severe) with nausea;  unusual bleeding or bruising; yellow eyes or skin. This medicine may cause a loss of potassium from your body. Signs of too much potassium loss are:   dryness of mouth; increased thirst; mood changes; muscle cramps or pain;  nausea or vomiting; unusual tiredness or weakness; weak or irregular heartbeat.


This medicine may interact with several other  drugs.

Be sure to tell your doctor about any medications you are currently  taking.


Store at room temperature in a tightly closed  container.

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About Genomic Medicine UK

Genomic Medicine UK is the home of comprehensive genomic testing in London. Our consultant medical doctors work tirelessly to provide the highest standards of medical laboratory testing for personalised medical treatments, genomic risk assessments for common diseases and genomic risk assessment for cancers at an affordable cost for everybody. We use state-of-the-art modern technologies of next-generation sequencing and DNA chip microarray to provide all of our patients and partner doctors with a reliable, evidence-based, thorough and valuable medical service.

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