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Metolazone is a prescription medication used to treat high blood pressure and fluid retention caused by congestive heart failure or kidney disease. This medication belongs to a group of drugs called diuretics ("water pills"), which help the body get rid of excess fluid  by increasing the amount of salt and water the kidneys remove from the blood.

This medication comes in tablet form and is usually taken once daily. Metolazone can be taken with or without food.

Common side effects of metolazone include headache, stomach pain, and dry mouth. Metolazone may cause drowsiness. Do not drive or operate heavy machinery until you know how it affects you.

Metolazone is a prescription medication used to treat high blood pressure and fluid retention caused by congestive heart failure or kidney disease.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

• Celltech Pharmaceuticals, Inc.

Serious side effects may occur. See "Drug Precautions" section.

Common side effects include:

• muscle weakness
• dizziness
• cramps
• thirst
• stomach pain
• stomach bloating
• upset stomach
• nausea or vomiting
• diarrhea or constipation
• headache
• hair loss
• dry mouth
• dizziness
• drowsiness
• fatigue
• insomnia
• tingling
• impotence
• blurred vision

This is not a complete list of metolazone side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• other medications for high blood pressure
• "loop diuretics" such as furosemide (Lasix) or torsemide (Demadex) and others
• nonsteroidal anti-inflammatory medications such as ibuprofen (Motrin, Nuprin) or naproxen (Aleve) and salicylates
• corticosteroids such as prednisone, hydrocortisone (Cortef), and dexamethasone (Decadron, Dexone, Hexadrol)
• lithium (Eskalith, Lithobid)
• medications for diabetes
• probenecid (Benemid)
• alcohol
• narcotics
• barbiturates such as amobarbital (Amytal), butalbital (Fioricet, Fiorinal), phenobarbital (Luminal) and others
• digoxin
• warfarin (Coumadin, Jantoven)

This is not a complete list of metolazone drug interactions. Ask your doctor or pharmacist for more information.

Metolazone can cause serious side effects including:

• electrolyte imbalance. This medication may affect electrolytes including sodium and potassium. Your doctor will check these levels using a blood test. Warning signs of electrolyte imbalance include:
  • dry mouth
  • thirst
  • weakness
  • lack of energy
  • drowsiness
  • restlessness
  • muscle pains or cramps
  • muscle fatigue
  • low blood pressure
  • decreased urination
  • fast heart rate
  • nausea and vomiting
• worsening of kidney disease
• worsening of gout
• sulfa allergy
• high blood glucose "sugar" concentrations in people with diabetes
• systemic lupus erythematosus (SLE or lupus) or worsening of lupus

This medication may cause drowsiness or dizziness. Do not drive or operate heavy machinery until you know how it affects you.

Do not take metolazone if you:

• are allergic to metolazone or any other ingredient of metolazone
• are not able to produce urine
• have severe liver disease

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of metolazone, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking metolazone, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• have liver disease
• have kidney disease
• have diabetes
• have systemic lupus erythematosus (SLE)
• have gout
• have electrolyte imbalances
• are allergic to sulfa medications or any other medications
• are pregnant or breastfeeding

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Metolazone falls into category B. There are no good studies that have been done in humans with metolazone. But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed.

Metolazone has been detected in human breast milk. Because of the possibility for adverse reactions in nursing infants from metolazone, a choice should be made whether to stop nursing or to stop use of metolazone. The importance of the drug to the mother should be considered.

• Take metolazone exactly as prescribed.
• This medication comes in tablet form and is usually taken once daily.
• Metolazone can be taken with or without food.
• Because metolazone increases urination, it is best taken in the morning to avoid having to get up in the night to urinate.
• If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose.

Take metolazone exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The metolazone dose your doctor recommends will be based on:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication

To treat fluid retention caused by congestive heart failure the recommended dose range is metolazone 5 to 20 mg once daily.

To treat fluid retention caused by kidney disease the recommended dose range is metolazone 5 to 20 mg once daily.

For the treatment of mild to moderate high blood pressure the recommended dose range is metolazone 2½ to 5 mg once daily.

If you take too much metolazone call your doctor or Poison Contol Center, or seek emergency medical attention right away.

• Store at room temperature between 15° and 30°C (59° and 86°F).
• Keep this and all medications out of the reach of children.