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metolazone Side Effects

Also known as: Zaroxolyn

Analysis of 10,872 adverse event reports submitted to the FDA from 2003 to 2025.

Total Reports

10,872

Death-Related

2,165

19.9% of reports

Hospitalizations

5,657

52.0% of reports

Top Indication

Product Used For Unknown Indication

Most Reported Adverse Reactions

DYSPNOEA
1,204
DEATH
867
ACUTE KIDNEY INJURY
790
NAUSEA
736
RENAL FAILURE
713
CARDIAC FAILURE CONGESTIVE
674
FATIGUE
648
DIARRHOEA
639
DIZZINESS
600
CHRONIC KIDNEY DISEASE
589
HYPOTENSION
579
ASTHENIA
572
HEADACHE
537
OEDEMA PERIPHERAL
524
FALL
507
FLUID RETENTION
489
PNEUMONIA
488
PAIN
426
VOMITING
387
WEIGHT INCREASED
383

Who Reports Side Effects

Gender Distribution

Female 5,391 (52%)
Male 4,873 (47%)
Unknown 14

Age Distribution

0-17 76 (1%)
18-44 496 (7%)
45-64 2,672 (35%)
65-74 2,184 (29%)
75+ 2,149 (28%)

Reporting Trend by Year

2003 2025

Reactions in Death Reports

Top reactions reported in 2,165 reports where death was an outcome. These are voluntarily reported and do not establish causation.

Reaction Reports
DEATH 866
DYSPNOEA 273
RENAL FAILURE 228
CARDIAC FAILURE CONGESTIVE 227
ACUTE KIDNEY INJURY 201
HYPOTENSION 160
CHRONIC KIDNEY DISEASE 151
CARDIAC FAILURE 134
NAUSEA 134
ASTHENIA 127
CARDIAC ARREST 124
PNEUMONIA 123
RESPIRATORY FAILURE 118
ATRIAL FIBRILLATION 112
OEDEMA PERIPHERAL 112
CONDITION AGGRAVATED 111
END STAGE RENAL DISEASE 110
DIARRHOEA 106
FATIGUE 99
SEPSIS 98

Reactions in Hospitalization Reports

Top reactions in 5,657 reports where hospitalization was an outcome.

Reaction Reports
DYSPNOEA 856
CARDIAC FAILURE CONGESTIVE 571
ACUTE KIDNEY INJURY 505
PNEUMONIA 444
HYPOTENSION 442
NAUSEA 436
ASTHENIA 413
FALL 398
RENAL FAILURE 391
FATIGUE 377
OEDEMA PERIPHERAL 374
FLUID RETENTION 370
DIARRHOEA 367
DIZZINESS 361
ANAEMIA 314
DEHYDRATION 307
GASTROINTESTINAL HAEMORRHAGE 296
CARDIAC FAILURE 292
ATRIAL FIBRILLATION 272
VOMITING 269

Nearby — Related Medications

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What the FAERS Data Reveals About metolazone Side Effects

The FDA Adverse Event Reporting System (FAERS) contains 10,872 voluntary reports linked to metolazone and its brand equivalents (Zaroxolyn), spanning 2003 through 2025. Of those, 2,165 (19.9%) listed death as an outcome and 5,657 (52.0%) involved hospitalization. The most common indication reported alongside adverse events was Product Used For Unknown Indication.

Demographic breakdowns help contextualize who is being exposed to the drug. Of reports with known sex, 52% were female and 47% male; age distribution skews toward 45-64, with 2,672 reports in that bracket. The single most reported reaction is dyspnoea with 1,204 submissions, followed by death and acute kidney injury.

FAERS is a signal-detection tool, not a scorecard. Reports are voluntary, and a single case may list multiple suspect drugs, so numbers above should not be read as incidence rates or per-patient risk. Widely prescribed drugs naturally accumulate more reports than niche therapies even when individual risk is low. These aggregates are useful for spotting patterns that merit further pharmacovigilance, not for choosing between medications. This page is for educational reference only and is not medical advice — speak with a licensed clinician about any side-effect concerns.