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What Is Metolazone?

Metolazone is a prescription thiazide-like diuretic and antihypertensive medicine. Current tablets contain 2.5 mg, 5 mg, or 10 mg. It treats fluid retention associated with congestive heart failure or kidney disease and is used for hypertension. Different metolazone formulations can have different absorption characteristics and are not automatically interchangeable.

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What Is Metolazone?

Metolazone is a prescription thiazide-like diuretic and antihypertensive medicine. Current tablets contain 2.5 mg, 5 mg, or 10 mg. It treats fluid retention associated with congestive heart failure or kidney disease and is used for hypertension. Different metolazone formulations can have different absorption characteristics and are not automatically interchangeable.

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How Does Metolazone Work?

Metolazone reduces sodium reabsorption in kidney tubules, increasing urinary excretion of sodium, chloride, and water. It also increases potassium loss. Removing excess fluid reduces swelling, while its diuretic and vascular effects contribute to lower blood pressure.

Who Is Treated With Metolazone?

Metolazone is used in patients with edema from congestive heart failure or kidney disease, including nephrotic syndrome and reduced kidney function. It is also used alone or with other antihypertensive medicines for elevated blood pressure. Patients with anuria, hepatic coma or precoma, or hypersensitivity to metolazone must not receive it.

How Is Metolazone Dosed?

For the current conventional metolazone tablets, edema associated with heart failure or kidney disease usually starts at 5 mg to 20 mg once daily. Mild to moderate hypertension commonly uses 2.5 mg to 5 mg once daily. Doses are adjusted according to response, blood pressure, fluid status, kidney function, and electrolyte measurements. Conventional metolazone tablets are not substituted milligram for milligram with Mykrox-type formulations.

What Serious Risks Are Linked to Metolazone?

Metolazone can cause rapid or severe reductions in sodium and potassium, potentially leading to weakness, confusion, muscle cramps, or dangerous heart rhythm disturbances. Other serious concerns include dehydration, low blood pressure, kidney dysfunction, elevated uric acid, and increased blood glucose. Combining metolazone with other diuretics can intensify fluid and electrolyte losses.

Frequently Asked Questions About Metolazone

What conditions does metolazone treat?

Metolazone treats edema from heart failure or kidney disease and is also used for hypertension.

What is the usual dose for edema?

Conventional metolazone tablets commonly start at 5 mg to 20 mg once daily for edema.

What is the usual dose for mild to moderate hypertension?

The usual dose is 2.5 mg to 5 mg once daily with the conventional tablet formulation.

Can metolazone lower potassium and sodium?

Yes. Metolazone can cause serious hypokalemia and hyponatremia, so electrolyte monitoring is part of treatment.

References

DailyMed - METOLAZONE tablet. https://www.dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1a8c38aa-362e-6bcc-e063-6294a90a1e05. Date Accessed October 14, 2026.

Metolazone. MedlinePlus. https://medlineplus.gov/druginfo/meds/a682345.html. Date Accessed October 14, 2026.

Metolazone. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Metolazone. Date Accessed October 14, 2026.

Metolazone. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK534203/. Date Accessed October 14, 2026.

Thiazide Diuretics. LiverTox. https://www.ncbi.nlm.nih.gov/books/NBK548680/. Date Accessed October 14, 2026.