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Metolazone and its role in edema management.

Abstract
Metolazone is commonly administered in conjunction with a loop diuretic to manage volume overload in patients otherwise resistant to loop diuretic therapy alone. Metolazone is a thiazide-type diuretic that is characterized by slow and sometimes erratic absorption when administered as the Zaroxylyn product. This absorptive profile together with the large volume of distribution and high degree of renal clearance for metolazone provide the pharmacologic basis for a favorable diuretic combination effect. Zaroxylyn should always be administered cautiously and only with a means of surveillance allowing the patient's weight to be carefully monitored so as to avoid excessive diuresis. If an excessive diuresis occurs with a metolazone and loop diuretic combination both drugs should be stopped temporarily. The temptation should be avoided to simply reduce the doses of either metolazone or the loop diuretic as a means to controlling an active diuresis.
AuthorsDomenic A Sica
JournalCongestive heart failure (Greenwich, Conn.) (Congest Heart Fail) 2003 Mar-Apr Vol. 9 Issue 2 Pg. 100-5 ISSN: 1527-5299 [Print] United States
PMID12671341 (Publication Type: Journal Article, Review)
CopyrightCopyright 2003 CHF, Inc.
Chemical References
  • Diuretics
  • Furosemide
  • Metolazone
Topics
  • Diuresis (drug effects)
  • Diuretics (therapeutic use)
  • Edema, Cardiac (complications, drug therapy, physiopathology)
  • Furosemide (therapeutic use)
  • Heart Failure (complications, drug therapy, physiopathology)
  • Humans
  • Metolazone (therapeutic use)

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