Intercranial hypertension (unlicensed indication)

Caution with ACE inhibitors. A weak diuretic.

Caution with ACE inhibitors. A weak diuretic.

2.5mg dose (higher doses not indicated in hypertension). Most patients do not develop hypokalaemia. Suggest check potassium level one month after initiation and annually thereafter (MeReC 10/94)

Monitor potassium level. Indicated in pulmonary oedema. Need large doses in renal failure

Combination products should be avoided, unless compliance is an issue

Prescribing to be in line with the prescribing support document.

• Prescribing guidance (PDF file)

Monitor potassium level. Indicated in pulmonary oedema. Need large doses in renal failure

Monitor potassium level. Indicated in pulmonary oedema. Need large doses in renal failure

Monitor potassium level. Indicated in pulmonary oedema. Need large doses in renal failure

2.5mg tablets only

Hospital only

Specialist recommendation (unlicensed).

There is now a UK licensed metolazone 5mg tablet available (Xaqua®). There are significant differences in bioavailability between Xaqua® and alternative unlicensed imported metolazone preparations.

Xaqua® tablets have up to approximately twice the bioavailability of other metolazone preparations.

If switching from another metolazone product to Xaqua® tablets or vice versa, a dose adjustment may be necessary, and individualised titration based on patient's response and tolerability is advised.

More information available from Specialist Pharmacy Service (SPS). We are awaiting guidance on switching to the licensed product – in the mean time please ensure that the patients are not inadvertently switched between products.

Retains potassium. Useful in liver cirrhosis and congestive heart failure with loop diuretic. Monitor potassium levels carefully.

Acne vulgaris in women that warrants treatment with antibiotics (off-label indication)