Metaxalone, a muscle relaxant, is a medicine with a similar name.

Metolazone is an oral diuretic drug, commonly classified with the thiazide diuretics, and marketed under the brand names Zaroxolyn and Mykrox. It is primarily used to treat congestive heart failure and high blood pressure. Metolazone indirectly decreases the amount of water reabsorbed into the bloodstream by the kidney, so that blood volume decreases and urine volume increases. This lowers blood pressure and prevents excess fluid accumulation in heart failure. Metolazone is often used together with loop diuretics such as furosemide or bumetanide, but these highly effective combinations can lead to dehydration and electrolyte abnormalities.

History

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Metolazone was developed in the 1970s. Its creator, Indian physician Dr. B. Vithal Shetty, has been active in helping the U.S. Food and Drug Administration review drug applications, and in the development of new medicines.Katague, David B. "Chemistry Reviewer Still in Lab". News Along the Pike (newsletter of the Food and Drug Administration' s Center for Drug Evaluation and Research). Volume 2, Issue 10. PDF. Accessed on January 25, 2006. Metolazone quickly gained popularity due to its lower renal toxicity compared to other diuretics (especially thiazides) in patients with renal insufficiency.

Structure

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Metolazone is a quinazoline, a derivative of the similar diuretic quinethazone, as well as a sulfonamide. It is related to analogs of 1,2,4-benzothiadizine-1,1-dioxide (benzothiadiazine). These drugs are called benzothiadiazides, or thiazides for short. Chemically, metolazone is not a substituted benzothiadiazine, and therefore is not technically a thiazide. However, since metolazone, as well other drugs like indapamide, act on the same target as thiazides and behave in a similar pharmacologic fashion, they are considered "thiazide-like diuretics". Therefore, they are often included in the thiazide diuretics despite not being thiazides themselves.*Jackson, Edwin K. "Diuretics". In Goodman & Gilman's The Pharmacological Basis of Therapeutics, 11th ed., edited by Laurence L. Brunton et al. New York: McGraw-Hill, 2006.

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