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Metolazone is used to treat high blood pressure. This is also used to treat the build-up of excess fluid and salt in your body (edema). Metolazone may be taken as part of combination therapy with other medications. This belongs to a class of drugs called diuretics. Diuretics cause you to urinate more. This helps remove excess fluid and salt from your body. Removing excess fluid and salt also helps lower your blood pressure. 

High blood pressure 

Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. High blood pressure generally develops over many years and it affects nearly everyone. You can have this condition for years without any symptoms. Damage to blood vessels and your heart continues and can be detected even without symptoms. For some people with high blood pressure, they may have headaches nosebleeds, or shortness of breath. Uncontrolled high blood pressure increases your risk of serious health problems such as stroke and heart attack.

Some people have high blood pressure caused by an underlying condition. This type of high blood pressure called secondary hypertension. It tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension including:

  • Kidney problems
  • Obstructive sleep apnea
  • Thyroid problems
  • Adrenal gland tumors
  • Certain defects you’re born within blood vessels
  • Certain medications (cold remedies, birth control pills, decongestants, and some prescription drugs)
  • Illegal drugs ( cocaine and amphetamines)


This is caused by excess fluid trapped in the tissues of your body. Though it can affect any part of your body, you may notice it more in your arms, hands, legs, or feet. Edema can be the result of medication, pregnancy, or an underlying disease. Signs of edema include:

  • Stretched or shiny skin
  • Increased abdominal size
  • Skin that retains a dimple after being pressed for several seconds
  • Swelling or puffiness of the tissue directly under your skin especially in your legs or arms 

Edema occurs when tiny blood vessels in your body leak fluid. The fluid builds up in surrounding tissues that lead to swelling. 

Mild cases of edema may result from:

  • Having premenstrual signs and symptoms
  • Sitting or staying in one position for too long
  • Eating too much salty food
  • Being pregnant

Edema can also be a side effect of some medications, including:

  • Estrogens
  • High blood pressure medications
  • Steroid drugs
  • Nonsteroidal anti-inflammatory drugs
  • Certain diabetes medications called thiazolidinediones

How It Works

Diuretics are sometimes referred to as water tablets. They remove excess fluid from the body by increasing the production of urine. Diuretics act in the kidneys. They work by causing the kidneys to increase the number of salts that are filtered out of the blood and into the urine. They draw water alongside them when these salts are filtered out of the blood by the kidneys. As diuretics increase the removal of salts from the blood, they also cause more water to be drawn out of the blood into the urine. 

Removing water from the blood lessens the volume of fluid circulating through the blood vessels. This subsequently decreases the pressure within the blood vessels. Therefore, this drug works effectively in lowering high blood pressure. 

How To Use

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. 

To be sure this medication is not causing harmful effects your blood will need to be tested regularly. Do not miss any scheduled appointments. If you need to have any type of surgery, tell the surgeon ahead of time that you are taking Metolazone. You may need to stop using the medicine for a short time. If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

This medication is taken by mouth with or without food. The dosage is based on your medical condition and response. If you take this too close to bedtime, you may need to wake up to urinate. It is best to take this medicine at least 4 hours before your bedtime. Let your doctor know if your condition does not improve or gets worse. 

Side Effects

Common side effects:

  • Diarrhea
  • Constipation
  • Loss of appetite
  • Headache
  • Stomach upset
  • Light-headedness
  • Blurred vision
  • Dizziness on standing
  • Chest pain or discomfort 
  • Low blood sodium
  • Low blood potassium
  • Electrolyte imbalance 


  • Metolazone can sometimes be used together with the diuretic furosemide. This will cause large volumes of urine to be produced. Your blood pressure and levels of salts in your body must be carefully monitored. 
  • This medicine may cause dizziness. You should be careful when performing some activities. 
  • While having this drug, you may need to have regular blood tests to monitor your kidney function. Your levels of salts in your blood should also be monitored. 
  • Metolazone can sometimes cause the level of sodium in your blood to fall too low. For this reason, following a very strict low salt diet should be avoided while you are taking this medicine.
  • This medicine should be used with caution in elderly people, people with diabetes, a history of gout, who are malnourished, and with hereditary blood disorders called porphyrias. 
  • This drug is not recommended for use in people with reduced levels of consciousness due to liver cirrhosis, whose kidneys are not producing urine, with a high level of potassium or sodium, or in people with a high level of calcium in their blood. 
  • Do not use this drug if you are allergic to this. Let your doctor know right away if you have any allergies. 
  • Inform your doctor first if you are breastfeeding, pregnant, or planning to become pregnant before taking this medication.