Merozolyn500mcg
Type:Tablet
Generic Name:Metolazone
Manufacturer:Unimed Unihealth Pharmaceuticals Ltd.
Price:৳5.00
Indication
Oedema, Hypertension
Administration
Should be taken with food. Take after breakfast.
Adult Dose
Oral Hypertension Adult: Initially, 1.25 mg daily, adjusted after 3-4 wk according to response. Usual dose: 2.5-5 mg daily, either alone or with other antihypertensives. Maintenance dose: 5 mg on alternate days. Formulations with enhanced bioavailability: 0.5-1 mg daily. Oedema Adult: 5-10 mg daily, increased if necessary to 20 mg daily. Max: 80 mg in 24 hr. Elderly: Initially, 2.5 mg/day or every other day.
Child Dose
Oedema 0.2-0.4 mg/kg/day PO in single daily dose or divided q12hr
Renal Dose
Renal impairment: Not necessary to supplement dose in hemodialysis or peritoneal dialysis
Contraindication
Anuria; hepatic coma or pre-coma. Pregnancy.
Mode of Action
Metolazone is a thiazide-like diuretic. It inhibits reabsorption of sodium in the distal tubules resulting in increased excretion of sodium and water, as well as potassium and hydrogen ions.
Precaution
Pre-diabetes or DM; gout; SLE; hepatic and renal impairment; hypercholesterolaemia. Correct electrolyte disturbances prior to therapy. Risk of cross-sensitivity with sulfonamides, sulfonylureas, carbonic anhydrase inhibitors, thiazides and loop diuretics. Lactation: Not recommended
Side Effect
Chest pain, palpitation, necrotising angiitis, orthostatic hypotension, syncope, venous thrombosis, vertigo, volume depletion; depression, dizziness, chills, drowsiness, fatigue, restlessness, headache, lightheadedness; petechiae, photosensitivity, hypersensitivity reactions; gout attacks, electrolyte disturbances; abdominal bloating, diarrhoea, abdominal pain, anorexia, constipation, epigastric distress, nausea, xerostomia, pancreatitis, vomiting; impotence; aplastic anaemia, thrombocytopenia, haemoconcentration, leukopenia; cholestatic jaundice, hepatitis; joint pain, muscle cramps, weakness, neuropathy, paraesthesia; blurred vision; increased BUN, glucosuria. Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis.
Interaction
Hypotensive and nephrotoxic effects of ACE inhibitors may be enhanced. Absorption may be reduced with bile acid sequestrants. Hyperglycaemic effect may be enhanced with diazoxide. May increase serum concentration and QTc-prolonging effect of dofetilide. May reduce lithium excretion. Hypotensive effect may be increased with alcohol. Potentially Fatal: Increased risk of nephrotoxicity with ciclosporin. Severe electrolyte disturbances may occur with furosemide.
