Does Metolazone Interact with Digitalis Glycosides?
Metolazone and Digitalis Glycosides have a major drug interaction according to U.S. FDA drug labeling data. Diuretic-induced hypokalemia can increase myocardial sensitivity to digitalis, resulting in serious arrhythmias. The mechanism involves hypokalemia increases myocardial sensitivity to digitalis. Patients taking both medications should consult their healthcare provider before starting, stopping, or changing the dosage of either drug. This information is based on official FDA drug labeling sourced from OpenFDA and the NIH National Library of Medicine.
- Severity
- Major
- Metolazone Class
- Thiazide-like Diuretic
- Management
- Close medical supervision required
- Data Source
- U.S. FDA via OpenFDA
How This Interaction Works
The interaction between Metolazone and Digitalis Glycosides occurs because hypokalemia increases myocardial sensitivity to digitalis. Clinically, this means diuretic-induced hypokalemia can increase myocardial sensitivity to digitalis, resulting in serious arrhythmias. This is classified as a major interaction, meaning it could cause serious harm if not properly managed. Your healthcare provider may need to adjust dosages, substitute one medication, or increase monitoring frequency.
What To Tell Your Doctor or Pharmacist
If you are taking Metolazone and your doctor is considering prescribing Digitalis Glycosides (or vice versa), make sure to:
- Inform your doctor and pharmacist of all current medications, including over-the-counter drugs and supplements
- Ask whether the benefits of combining these medications outweigh the risks for your specific situation
- Ask what symptoms to watch for that would indicate the interaction is causing problems
- Ask how frequently you should be monitored while these are co-prescribed
- Ask whether any dosage adjustments are needed
- Never stop or change either medication without first consulting your healthcare provider