Metolazone

Mesoridazine besylate Methoqualone Metoclopramide HCI Metolazone Midazolam maleate Moxisylyte Nadolol Naloxone... 

Electroneutral NaCl transport in the distal convoluted tubule is inhibited by the class of thiazide diuretics (chlorothiazide, hydrochlorothiazide, metolazone, chlorthalidone, and others). Thiazides interfere with the Cl binding site of NCC, and cause a relatively small... 

C4H10O2 534-15-6) see Metolazone acetaldehyde (4-methoxyphenyl)hydrazone (C9H12N2O 13815-71-9) see Indometacin acetaldehyde thiosemicarhazone (C3H7NJS 2302-95-6) see Sulfamethizole acetamide... 

C1H03S 7790-94-5) see Actinoquinol Azosemide Bendroflumethiazide Clopamide Diclofenamide Diethylstilbestrol disulfate Dorzolamide Furosemide Glibenclamide Glimepiride Hydroflumethiazide Lomoxicam Mafenide Meticrane Metolazone Saccharin Sildenafil Sodium picosulfate Sulfanilamide Tiotixene Tripamide Xipamide... 

Consider combining the loop diuretic with either a thiazide diuretic or metolazone... 

Two types of diuretics are used for volume management in HF thiazides and loop diuretics. Thiazide diuretics such as hydrochlorothiazide, chlorthalidone, and metolazone block sodium and chloride reabsorption in the distal convoluted tubule. Thiazides are weaker than loop diuretics in terms of effecting an increase in urine output and therefore are not utilized frequently as monotherapy in HF. They are optimally suited for patients with hypertension who have mild congestion. Additionally, the action of thiazides is limited in patients with renal insufficiency (creatinine clearance less than 30 mL/minute) due to reduced secretion into their site of action. An exception is metolazone, which retains its potent action in patients with renal dysfunction. Metolazone is often used in combination with loop diuretics when patients exhibit diuretic resistance, defined as edema unresponsive to loop diuretics alone. 

Prolonged administration of loop diuretics can lead to a second type of diuretic resistance. Enhanced delivery of sodium to the distal tubule can result in hypertrophy of distal convoluted cells.17 Subsequently, increased sodium chloride absorption occurs in the distal tubule which diminishes the effect of the loop diuretic on sodium excretion. Addition of a distal convoluted tubule diuretic, such as metolazone or hydrochlorothiazide, to a loop diuretic can result in a synergistic increase in urine output. There are no data to support the efficacy of one distal convoluted tubule diuretic over another. The common practice of administering the distal convoluted tubule diuretic 30 to 60 minutes prior to the loop diuretic has not been studied, although this practice may first inhibit sodium reabsorption at the distal convoluted tubule before it is inundated with sodium from the loop of Henle. 

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