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metolazone

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Brand names: Zaroxolyn

Thiazide-Like Diuretic Rx

Metolazone is a water pill that helps your body get rid of extra salt and water. It can also lower blood pressure.

Drug Pricing (NADAC)

Generic Price

$0.43/unit

Generic Available

Yes (10 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

Metolazone treats water retention (edema) caused by heart failure or kidney problems.

Common side effects

Dizziness, Lightheadedness, Drowsiness

Key warnings

If you have trouble urinating, are in a hepatic coma or precoma, or are allergic to metolazone, you should not take this medicine.

How It Works

Metolazone is a diuretic, which means it helps your kidneys remove salt and water from your body. This reduces the amount of fluid in your blood vessels, which can lower blood pressure and reduce swelling. It belongs to a class of drugs called thiazide-like diuretics.

How to Take It

Take metolazone once a day. Your doctor will adjust your dose to find what works best for you. It may take a few days to weeks to see the full effect, especially for blood pressure. Follow your doctor's instructions carefully and don't change your dose without talking to them.

Pregnancy & Breastfeeding

Using diuretics during pregnancy can expose the mother and fetus to unnecessary risks. Talk to your doctor about the risks and benefits of taking metolazone while pregnant or breastfeeding. It should only be used if medically necessary.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store metolazone tablets at room temperature (68° to 77°F) and protect them from light. Keep out of the reach of children.

Side Effects (from patient reports)

Based on 7,458 FDA adverse event reports.

Difficulty breathing
1,204
Death
868
Sudden kidney damage
790
Feeling sick to your stomach
735
Kidney failure
712
Congestive heart failure
674
Tiredness
648
Diarrhea
639
Feeling unsteady
599
Long-term kidney disease
589

FDA Adverse Event Report Analysis

Detailed analysis of 10,872 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.

Total Reports

10,872

Death-Related Reports

2,165

Hospitalization Reports

5,657

Top Indication

Product Used For Unknown Indication

Gender Distribution

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

Age Distribution

0–17 76
18–44 496
45–64 2,672
65–74 2,184
75+ 2,149

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 DYSPNOEA 1,204
2 DEATH 867
3 ACUTE KIDNEY INJURY 790
4 NAUSEA 736
5 RENAL FAILURE 713
6 CARDIAC FAILURE CONGESTIVE 674
7 FATIGUE 648
8 DIARRHOEA 639
9 DIZZINESS 600
10 CHRONIC KIDNEY DISEASE 589
11 HYPOTENSION 579
12 ASTHENIA 572
13 HEADACHE 537
14 OEDEMA PERIPHERAL 524
15 FALL 507

Reactions in Death 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

Reactions in Hospitalization 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

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

If you have trouble urinating, are in a hepatic coma or precoma, or are allergic to metolazone, you should not take this medicine. Using diuretics when pregnant can be dangerous to the baby. Only use this medicine during pregnancy if absolutely necessary for a medical condition.

Common Questions

Can I take metolazone if I'm pregnant?
Talk to your doctor. Diuretics during pregnancy can be risky.
What should I do if I feel dizzy after taking metolazone?
Lie down until the dizziness passes. Avoid sudden movements.
How long does it take for metolazone to start working?
It starts working within an hour, but it may take weeks to lower blood pressure.
Can I drink alcohol while taking metolazone?
Talk to your doctor. Alcohol can worsen some side effects.
What if I miss a dose?
Take it when you remember. If it's close to your next dose, skip it.
Does metolazone interact with other medications?
Yes, it can. Tell your doctor about all medications you take.
Can metolazone cause dehydration?
Yes, it can. Drink plenty of fluids.
How often will I need blood tests?
Your doctor will decide based on your condition and response to the drug.
Can I stop taking metolazone suddenly?
No, talk to your doctor before stopping. Stopping suddenly can be dangerous.
What are the ingredients in metolazone tablets?
Metolazone, colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose, and dye.
What are the common side effects of metolazone?
The most commonly reported side effects of metolazone include Dizziness, Lightheadedness, Drowsiness, Fatigue, Weakness. Based on 7,458 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
What drug class is metolazone?
metolazone belongs to the Thiazide-Like Diuretic drug class. It requires a prescription (Rx). Metolazone treats water retention (edema) caused by heart failure or kidney problems.
Is metolazone safe during pregnancy?
Using diuretics during pregnancy can expose the mother and fetus to unnecessary risks. Talk to your doctor about the risks and benefits of taking metolazone while pregnant or breastfeeding. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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Related Health & Safety Data

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What the FDA Data Shows for metolazone

The FDA label for metolazone (sold under brand names such as Zaroxolyn) classifies it as a prescription-only medication in the Thiazide-Like Diuretic class. Metolazone treats water retention (edema) caused by heart failure or kidney problems. Official labeling lists 7 commonly reported side effects, including Dizziness, Lightheadedness, Drowsiness.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 7,458 voluntary reports. Interaction data is drawn directly from FDA-approved prescribing information. NADAC pricing from CMS shows a generic unit cost of $0.43.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: December 24, 2024

All federal data sources used on this page