Brand and Other Names:Zaroxolyn
- Classes: Diuretics, Other
Dosing & Uses
Dosage Forms & Strengths
2.5-5 mg PO once daily; may be increased to 20 mg once daily PRN
2.5-10 mg PO once daily initially; may be gradually increased to 20 mg once daily
Renal impairment: Not necessary to supplement dose in hemodialysis or peritoneal dialysis
- Normal saline may be used for volume replacement
- Dopamine or norepinephrine may be used to treat hypotension
- Discontinue treatment if no symptoms are apparent after 6 hours
Dosage Forms & Strengths
Increased risk of azotemia and electrolyte depletion when used in combination with diuretics in elderly
2.5 mg PO once daily or every other day
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Increased blood urea nitrogen (BUN)
Toxic epidermal necrolysis
Documented hypersensitivity to metolazone or sulfonamides
Hepatic coma or precoma
Use with caution in diabetes mellitus, fluid or electrolyte imbalance, hypercholesterolemia, hyperuricemia or gout, hypotension, systemic lupus erythematosus, previous sympathectomy, liver disease, renal disease
Avoid concurrent use with lithium (reduction of lithium dosage by 50% may be necessary)
May aggravate digitalis toxicity
Photosensitization may occur
Electrolyte disturbances (eg, hyponatremia, hypochloremic alkalosis) may occur
Sensitivity reactions may occur with or without history of allergy or asthma
Patients allergic to sulfa may show cross-sensitivity
May deleteriously alter lipid/glucose metabolism
Mykrox not therapeutically interchangeable with Zaroxolyn
Risk of male sexual dysfunction
Pregnancy & Lactation
Pregnancy category: B
Lactation: Not recommended
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Inhibits reabsorption of sodium in distal tubules, causing increased excretion of water and of sodium, potassium, and hydrogen ions
Onset: Diuresis, 1 hr
Duration: 24 hr
Peak plasma time: Zaroxolyn, 8 hr
Protein bound: 95%
Minimally metabolized; site of metabolism unspecified
Half-life: 20 hr
Dialyzable: Hemodialysis, no
Excretion: Urine (80%), bile (10%)
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|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
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|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
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