Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Zaroxolyn (Metolazone). If you are concerned about side effects, discuss the risks and benefits of Zaroxolyn (Metolazone) with your doctor.

The following side effects have been reported by at least 1% of people taking Zaroxolyn (Metolazone). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• decreased sexual ability
• Diarrhea
• dizziness or lightheadedness when getting up from a lying or sitting position
• fatigue
• increased sensitivity of skin to sunlight
• loss of appetite
• upset stomach

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• flu-like symptoms (e.g., Fever or chills, sore throat, cough, achiness)
• joint pain
• skin rash or Hives
• signs and symptoms of too much potassium loss:
• dryness of mouth
• increased thirst
• irregular heartbeat
• mood or mental changes
• muscle cramps or pain
• nausea or vomiting
• unusual tiredness or weakness
• weak pulse
• signs and symptoms of too much sodium loss:
• confusion
• convulsions
• decreased mental activity
• irritability
• muscle cramps
• unusual tiredness or weakness

• signs of kidney problems (e.g., increased urination at night, decreased urine production, blood in the urine, change of urine colour)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of pancreatitis (e.g., abdominal pain on the upper left side, back pain, nausea, fever, chills, rapid heartbeat, swollen abdomen)
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Zaroxolyn (Metolazone).

Each pink, slightly biconvex tablet, debossed with its numeric strength on one side and "ZAROXOLYN" on the other, contains Zaroxolyn (Metolazone) 2.5 mg. Nonmedicinal ingredients: microcrystalline cellulose, D&C Red No. 33 Aluminum Lake, and magnesium stearate. Zaroxolyn (Metolazone) does not contain alcohol, gluten, lactose, paraben, sucrose, or tartrazine.

Do not take Zaroxolyn (Metolazone) if you:

• are allergic to Zaroxolyn (Metolazone) or any ingredients of Zaroxolyn (Metolazone)
• are unable to urinate

Do not give Zaroxolyn (Metolazone) to people who are in hepatic coma or pre-coma.

There may be an interaction between Zaroxolyn (Metolazone) and any of the following:

• aclidinium
• alcohol
• Aldesleukin
• Allopurinol
• alpha blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• angiotensin converting enzyme inhibitors (ACEIs; Captopril, Ramipril)
• antihistamines (e.g., cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• atropine
• barbiturates (e.g., butalbital, Phenobarbital)
• belladonna
• Benztropine
• beta 2 agonists (bronchodilators; e.g., salbutamol, formoterol, Indacaterol)
• brimonidine
• calcium supplements (e.g., calcium carbonate, calcium citrate)
• Carbamazepine
• Cholestyramine
• Colestipol
• corticosteroids (e.g., beclomethasone, Dexamethasone, fluticasone, Hydrocortisone, Prednisone)
• Cyclobenzaprine
• Cyclophosphamide
• Darifenacin
• diabetes medications (e.g., chlorpropamide, insulin, Glyburide, Metformin, Rosiglitazone)
• Digoxin
• Disopyramide
• other diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• dofetilide
• Duloxetine
• Flavoxate
• glycopyrrolate
• ipratropium
• Ivabradine
• ketotifen
• levodopa
• lithium
• medications that lower blood pressure Methadone
• Methylphenidate
• multivitamin/mineral supplements
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• nonsteroidal anti-inflammatory medications (NSAIDs; e.g., Ibuprofen, Naproxen)
• Obinutuzumab
• orphenadrine
• Oxcarbazepine
• Oxybutynin
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• pentixifylline
• Porfimer
• quinine
• quinidine
• scopolamine
• selective serotonin reuptake inhibitors (SSRIs; e.g., Citalopram, Fluoxetine, Paroxetine, Sertraline)
• sodium phosphates
• Solifenacin
• tiotropium
• Tizanidine
• tolcapone
• Tolterodine
• Topiramate
• Tranylcypromine
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• umeclidinium
• Verteporfin
• vitamin D analogues (e.g., alfacalcidol, Calcitriol, cholecalciferol)
• Yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Zaroxolyn (Metolazone). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take Zaroxolyn (Metolazone).

Diabetes: If you have diabetes, your doctor should closely monitor your condition while you are taking Zaroxolyn (Metolazone), as it may affect blood sugar control (by increasing blood sugar levels).

Electrolytes: Zaroxolyn (Metolazone) may cause imbalances of electrolytes in the blood such as potassium, sodium, and magnesium. The signs of electrolyte imbalance include:

• drowsiness
• Dry Mouth
• lethargy
• Low Blood Pressure
• muscle fatigue
• muscle pains or cramps
• racing heart rate
• reduced urine output
• restlessness
• stomach disturbances such as nausea and vomiting
• thirst
• weakness

If you have these symptoms, contact your doctor as soon as possible.

Gout: High blood uric acid levels may be brought on by Zaroxolyn (Metolazone). This may result in a gout attack for people with a history of gout. If you have a history of gout, discuss with your doctor how Zaroxolyn (Metolazone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zaroxolyn (Metolazone), and whether any special monitoring is needed.

Kidney and liver function: If you have reduced kidney or liver function, discuss with your doctor how Zaroxolyn (Metolazone) may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Zaroxolyn (Metolazone), and whether any special monitoring is needed.

Low blood pressure: Some people taking Zaroxolyn (Metolazone) experience sudden blood pressure drops when getting up from a sitting or lying position. These blood pressure drops could lead to dizziness, lightheadedness, and falls. If you experience this problem, try getting up more slowly. If it persists or if you faint, contact your doctor.

Systemic Lupus erythematosus: Zaroxolyn (Metolazone) can worsen or activate the symptoms of lupus. If you experience swollen and painful joints, fever, fatigue, or rash on the nose and cheeks while taking Zaroxolyn (Metolazone), contact your doctor.

Pregnancy: Zaroxolyn (Metolazone) should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Zaroxolyn (Metolazone), contact your doctor immediately.

Breast-feeding: Zaroxolyn (Metolazone) passes into breast milk. If you are a breast-feeding mother and are taking Zaroxolyn (Metolazone), it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Zaroxolyn (Metolazone) have not been established for children.