Drug interactions
Metolazone + Trilostane
Severity: Moderate
Metolazone and Trilostane: 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
Trilostane suppresses adrenal steroid synthesis, including aldosterone, and so reduces potassium excretion, which can offset the hypokalemia caused by metolazone. It may also increase sodium loss and lower blood pressure, and hyperkalemia is possible in susceptible patients.
What this interaction means in plain words
Metolazone and Trilostane 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.
Why it happens
Inhibition of 3-beta-hydroxysteroid dehydrogenase lowers aldosterone, adding to diuretic natriuresis while reducing potassium loss.
What to do
Monitor serum sodium, potassium and blood pressure, and avoid unnecessary potassium supplements during combined use.
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
Frequently asked questions
Can I take Metolazone with Trilostane?
MediHelp rates the interaction as moderate. Metolazone and Trilostane 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. Trilostane suppresses adrenal steroid synthesis, including aldosterone, and so reduces potassium excretion, which can offset the hypokalemia caused by metolazone. It may also increase sodium loss and lower blood pressure, and hyperkalemia is possible in susceptible patients.
How serious is the interaction between Metolazone and Trilostane?
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 sodium, potassium and blood pressure, and avoid unnecessary potassium supplements during combined use.
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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