Hypertension Home > Zaroxolyn Warnings and Precautions

It is important to be aware of the risks of taking Zaroxolyn. Warnings and precautions for the drug involve the potential of extremely low blood pressure, possible drug interactions, and the danger of electrolyte imbalances. Prior to taking Zaroxolyn, be sure to tell your healthcare provider about any medical conditions you may have, as well as any medications you are currently taking.

Zaroxolyn: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Zaroxolyn® (metolazone) if you have:
  • Liver disease, including liver failure or cirrhosis
  • Kidney disease or kidney failure
  • Diabetes
  • Systemic lupus erythematosus (lupus or SLE)
  • Gout
  • Fluid or electrolyte problems
  • Any allergies, including allergies to sulfa drugs, foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Tell your healthcare provider about any other medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Zaroxolyn Warnings and Precautions

Warnings and precautions to be aware of prior to taking Zaroxolyn include the following:
  • The medication may affect electrolytes in the blood (especially sodium and potassium). Therefore, your healthcare provider will regularly check these levels. If you notice any symptoms of a possible electrolyte imbalance, contact your healthcare provider immediately. These symptoms may include:
    • Dry mouth
    • Thirst
    • Weakness
    • Lethargy
    • Drowsiness
    • Restlessness
    • Muscle pain or muscle cramps
    • Low blood pressure (hypotension)
    • Decreased urination
    • A rapid heart rate (tachycardia) or an irregular heart rhythm (arrhythmia)
    • Nausea or vomiting.
  • If kidney problems seem to be getting worse (especially for those who have severe kidney disease), Zaroxolyn should be stopped, as the medication may be causing this.
  • Several medicines can interact with Zaroxolyn (see Zaroxolyn Drug Interactions).
  • Zaroxolyn can make gout worse.
  • If you are allergic to sulfonamide ("sulfa" drugs), you may also be allergic to Zaroxolyn.
  • The medication may cause extremely low blood pressure in some people. This is more likely to happen when Zaroxolyn is first started or the dosage is changed. It is also more likely to happen in people who are on dialysis, who have congestive heart failure, who have diarrhea or vomiting, or who have excessive sweating. This is why it is important to drink fluids regularly while taking Zaroxolyn. If you have any possible symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting spells, contact your healthcare provider. If you have fainted, stop taking the drug until you have talked to your healthcare provider. 
  • Do not drive, operate any heavy machinery, or perform any other tasks that require alertness until you know how Zaroxolyn affects you.
  • Zaroxolyn may cause high blood sugar (hyperglycemia) in people with diabetes or, in some cases, may even cause diabetes in people without a history of the condition.
  • The medication can cause systemic lupus erythematosus (lupus or SLE) or make lupus worse.
  • Zaroxolyn is considered a pregnancy Category B medication. This means that it is probably safe for use during pregnancy, although the full risks are unknown. Talk to your healthcare provider about the risks and benefits of using Zaroxolyn during pregnancy (see Metolazone and Pregnancy).
  • Zaroxolyn does pass through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to taking the drug (see Metolazone and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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