Zaroxolyn (Metolazone)

Do’s

• Zaroxolyn is typically taken by mouth with or without food as directed by a healthcare provider, usually once daily. The dosage is based on the individual's medical condition and response to treatment. 
• Take this medication regularly to derive the most benefit from it. It should be taken at the same time each day as directed, even if the individual feels well. It may take up to 3 to 6 weeks to see a lowering of blood pressure.
• If this medication is taken too close to bedtime, it may cause the need to wake up to urinate. Take it at least 4 hours before bedtime.
• The dosage may occasionally be changed by the healthcare provider to ensure the best results.
• Zaroxolyn may interact with other medications such as cholestyramine and colestipol, which can decrease the absorption of metolazone. If taking either of these drugs, separate Zaroxolyn from cholestyramine by at least 4 hours and from colestipol by at least 2 hours. 
• If your condition lasts or gets worse, inform your healthcare provider.

Don'ts

• Do not stop taking this medication without consulting your healthcare provider, as most people with high blood pressure do not feel sick.
• Do not use this medicine in larger or smaller amounts or for longer than recommended.

Common Side Effects:

• Decreased potassium levels
• Increased blood sugar levels
• Changes in uric acid levels

Serious Side Effects:

• Fainting
• Signs of infection (such as sore throat that doesn't go away, fever)
• Numbness/tingling of the arms/legs
• Decreased sexual ability
• Easy bleeding/bruising
• Signs of liver problems (such as nausea/vomiting that doesn't stop, yellowing eyes/skin, stomach/abdominal pain)
• Signs of kidney problems (such as change in the amount of urine) 

This is not an exhaustive list of side effects, and individuals may experience other side effects not listed here. If you experience any unusual or concerning symptoms while taking Zaroxolyn, consult your healthcare provider for further guidance and evaluation.

Using Zaroxolyn during pregnancy could cause side effects in the newborn baby, such as blood cell problems or jaundice (yellowing of the skin or eyes). Inform your healthcare provider if you are pregnant or if you become pregnant while using Zaroxolyn 

Consult with a healthcare provider for guidance on the use of Zaroxolyn during breastfeeding, as the medication may pass into breast milk and could potentially affect the nursing infant.

Before taking Zaroxolyn, inform your healthcare provider if you are allergic to metolazone, sulfa drugs, thiazides, or any other medications.

Zaroxolyn may deleteriously alter lipid/glucose metabolism and has a risk of male sexual dysfunction. Monitoring for hypotension if administered concurrently with hypotensive agents is essential.

In patients with renal disease, if azotemia and oliguria worsen during treatment, therapy should be discontinued.

Zaroxolyn may render patients volume depleted if given in the morning of surgery, and blood pressure may be labile during general anesthesia.

Clinical studies of Zaroxolyn did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

When taking Zaroxolyn, inform your healthcare provider about all the medications you are currently taking, as certain drug interactions may occur. Your healthcare provider may need to adjust the dose or take other precautions based on the medications you are using.

Follow your healthcare provider's instructions and discuss any concerns or questions about the warnings and precautions of Zaroxolyn.