Two medicines, side by side
Metolazone vs hydrochlorothiazide
Metolazone and hydrochlorothiazide are both labeled for high blood pressure, heart failure and edema (fluid retention). Drugs@FDA records approvals of metolazone since 1973 and of hydrochlorothiazide since 1959. Pharmacies paid $0.233 per metolazone 2.5 mg tablet and $0.0115 per hydrochlorothiazide 25 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Hydrochlorothiazide's other strengths are brand-only: $4.46 per mL (Inzirqo 10 mg/mL oral suspension). In FDA's classes, metolazone is a thiazide-like diuretic and hydrochlorothiazide a thiazide diuretic.
Check it at the source: the metolazone FDA label on DailyMed (effective December 11, 2025); the hydrochlorothiazide FDA label on DailyMed (effective June 12, 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 hydrochlorothiazide record
Hydrochlorothiazide (Inzirqo) · label of June 12, 2026
Used for
From the label: indicationsHydrochlorothiazide tablets USP are indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Hydrochlorothiazide tablets USP have also been found useful in edema due to various forms of renal dysfunction such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure. […]
On the market
- Earliest approval on file
- February 12, 1959
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0115 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 7
Source: FDA drug labels via openFDA (Metolazone label of December 11, 2025, Hydrochlorothiazide label of June 12, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do metolazone and hydrochlorothiazide differ on the record?
In FDA's classes, metolazone is a thiazide-like diuretic and hydrochlorothiazide a thiazide diuretic.
Generics: metolazone since 2003; hydrochlorothiazide since 1973 (Drugs@FDA).
| Metolazone | Hydrochlorothiazide | |
|---|---|---|
| Labeled for | High blood pressure, Edema (fluid retention), Heart failure | Heart failure, High blood pressure, Edema (fluid retention) |
| Pharmacologic class | Thiazide-like Diuretic | Thiazide Diuretic |
| How it works (label) | n/a | n/a |
| Half-life (label) | n/a | When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 and 14.8 hours. |
| Earliest approval on file (Drugs@FDA) | November 27, 1973 | February 12, 1959 |
| First generic approved | December 19, 2003 | January 12, 1973 |
| Generic labelers (NDC) | 19 labelers | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.233 per tablet (Metolazone 2.5 mg tablet) | $0.0115 per tablet (Hydrochlorothiazide 25 mg tablet) |
| 12-month price change | +8% | -7% |
| Boxed warning | No | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 0 | 7 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 11,175 | 144,413 |
| 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