Metolazone drug group moa
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metolazone prescribing information thiazide-like diuretic mechanism of action
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metolazone diuretic
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Metolazone
- Drug group: Thiazide-like diuretic (quinazoline derivative).
- Site of action: Mainly the early distal convoluted tubule, at the cortical diluting segment.
- Mechanism of action: Inhibits the Na⁺-Cl⁻ cotransporter (NCC) on the luminal membrane. This reduces sodium and chloride reabsorption, causing increased excretion of Na⁺, Cl⁻, and water.
Important effects
- Increased distal sodium delivery causes increased potassium and hydrogen ion loss, so it can cause hypokalemic metabolic alkalosis.
- Also reduces calcium excretion, similar to thiazides.
- Often combined with a loop diuretic, such as furosemide, for resistant edema because of sequential nephron blockade.
- Unlike conventional thiazides, it may still cause diuresis in substantial renal impairment. DailyMed prescribing information describes its action as inhibition of renal sodium reabsorption at the cortical diluting site.
Textbook support: metolazone is a thiazide-like drug that inhibits the NaCl cotransporter in the distal tubule. Brenner and Rector's The Kidney, Diuretics section.
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