Two medicines, side by side
Metolazone vs chlorthalidone
Metolazone and chlorthalidone are both labeled for high blood pressure, heart failure and edema (fluid retention). Drugs@FDA records approvals of metolazone since 1973 and of chlorthalidone since 1960. Pharmacies paid $0.233 per metolazone 2.5 mg tablet and $0.0743 per chlorthalidone 25 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Chlorthalidone's other strengths are brand-only: $0.957 per Hemiclor 12.5 mg tablet.
Check it at the source: the metolazone FDA label on DailyMed (effective December 11, 2025); the chlorthalidone FDA label on DailyMed (effective August 5, 2026).
Highlights of the metolazone record
Metolazone (Zaroxolyn) · label of December 11, 2025
Used for
From the label: indicationsMetolazone tablets, USP, are indicated for the treatment of salt and water retention including: edema accompanying congestive heart failure; edema accompanying renal diseases, including the nephrotic syndrome and states of diminished renal function. Metolazone tablets, USP, are also indicated for the treatment of hypertension, alone or in combination with other antihypertensive drugs of a different class. […]
On the market
- Earliest approval on file
- November 27, 1973
- Generic labelers
- 19 labelers
- Pharmacy cost
- $0.233 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the chlorthalidone record
Chlorthalidone (Hygroton) · label of August 5, 2026
Used for
From the label: indicationsDiuretics such as chlorthalidone are indicated in the management of hypertension either as the sole therapeutic agent or to enhance the effect of other antihypertensive drugs in the more severe forms of hypertension. Chlorthalidone is indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. […]
On the market
- Earliest approval on file
- April 7, 1960
- Generic labelers
- 36 labelers
- Pharmacy cost
- $0.0743 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Metolazone label of December 11, 2025, Chlorthalidone label of August 5, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do metolazone and chlorthalidone differ on the record?
Both are in FDA's class thiazide-like diuretics.
Generics: metolazone since 2003; chlorthalidone since 1981 (Drugs@FDA).
| Metolazone | Chlorthalidone | |
|---|---|---|
| Labeled for | High blood pressure, Edema (fluid retention), Heart failure | High blood pressure, Heart failure, Edema (fluid retention) |
| Pharmacologic class | Thiazide-like Diuretic | Thiazide-like Diuretic |
| How it works (label) | n/a | n/a |
| Half-life (label) | n/a | The mean half-life following a 50 to 200 mg dose is 40 hours. |
| Earliest approval on file (Drugs@FDA) | November 27, 1973 | April 7, 1960 |
| First generic approved | December 19, 2003 | February 26, 1981 |
| Generic labelers (NDC) | 19 labelers | 36 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.233 per tablet (Metolazone 2.5 mg tablet) | $0.0743 per tablet (Chlorthalidone 25 mg tablet) |
| 12-month price change | +8% | -12% |
| Boxed warning | No | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 0 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 11,175 | 11,545 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to metolazone
- every medicine labeled for the same conditions