Drug interactions
Amiloride + Metolazone
Severity: Moderate
Amiloride and Metolazone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Metolazone causes potassium loss while amiloride retains potassium, so the two have opposing effects on serum potassium. The combination is often used deliberately to prevent hypokalaemia, but potassium may become too low or too high, especially with renal impairment.
What this interaction means in plain words
Amiloride and Metolazone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amiloride belongs to Cardiovascular; Metolazone belongs to Cardiovascular.
Why it happens
Opposing pharmacodynamic effects: metolazone increases distal potassium excretion, while amiloride blocks ENaC and reduces potassium secretion.
What to do
Monitor serum potassium, sodium and renal function after starting and during dose changes. Avoid additional potassium supplements unless hypokalaemia is documented.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Metolazone
Other interactions of Amiloride
- Amiloride + Eplerenone Contraindicated
- Amiloride + Spironolactone Contraindicated
- Amiloride + Triamterene Contraindicated
- Aceclofenac + Amiloride Major
- Acemetacin + Amiloride Major
- Amiloride + Amlodipine-benazepril Major
Frequently asked questions
Can I take Amiloride with Metolazone?
MediHelp rates the interaction as moderate. Amiloride and Metolazone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Metolazone causes potassium loss while amiloride retains potassium, so the two have opposing effects on serum potassium. The combination is often used deliberately to prevent hypokalaemia, but potassium may become too low or too high, especially with renal impairment.
How serious is the interaction between Amiloride and Metolazone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium, sodium and renal function after starting and during dose changes. Avoid additional potassium supplements unless hypokalaemia is documented.
What other medicines interact with Metolazone?
MediHelp also lists interactions of Metolazone with, for example, Amifostine, Amlodipine-hydrochlorothiazide-valsartan, Amlodipine-olmesartan-hydrochlorothiazide. The full list is on the Metolazone page.
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