Diuretic Effect of Metolazone Pre-dosing Versus Concurrent Dosing



Status:Recruiting
Conditions:Cardiology
Therapuetic Areas:Cardiology / Vascular Diseases
Healthy:No
Age Range:18 - 89
Updated:3/8/2019
Start Date:January 1, 2019
End Date:August 1, 2019
Contact:Mallory Mouradjian, PharmD
Email:mmouradjian@rx.umaryland.edu
Phone:4012483433

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Diuretic Effect of Metolazone Pre-dosing Versus Concurrent Dosing With Furosemide: a Pilot Study

The purpose of this study is to examine whether administering metolazone 60 minutes prior to
furosemide increases urine output compared with administering metolazone and furosemide
concomitantly. Participants will have equal chance of being assigned to each group.

Diuretic resistance is common among patients with acute decompensated heart failure, and one
strategy for overcoming this phenomenon is sequential nephron blockade with loop plus
thiazide-type diuretics. Metolazone is an oral thiazide-type diuretic commonly used for this
purpose. Due to its delayed absorption, some clinicians suggest that metolazone be given
30-60 minutes prior to the loop diuretic. However, the efficacy and safety of such a strategy
has not been investigated despite its added complexity. The purpose of this study is to
investigate whether pre-dosing with metolazone confers a difference in efficacy and safety
compared to administering it at the same time as furosemide.

Inclusion Criteria:

- Admission within 48 hours for acute decompensated heart failure with at least one
symptom and one sign of volume overload

- Receipt of loop diuretic prior to admission

- Plan to administer furosemide 120 - 160 mg IV bolus twice daily over the next 24 hours
with additional diuresis deemed necessary

- If patient is concurrently administered intravenous vasodilator or inotrope, the dose
of vasodilator or inotrope must be stable for 6 hours prior to enrollment with a plan
to continue the same dose for the 24 hour duration of this study

Exclusion Criteria:

- Metolazone prescribed prior to admission

- Receipt of continuous intravenous infusion of furosemide

- Cirrhosis or end stage renal disease

- Non-English speaking patients
We found this trial at
1
site
22 S Greene St
Baltimore, Maryland 21201
(410) 328-8667
Phone: 401-248-3433
University of Maryland Medical Center Founded in 1823 as the Baltimore Infirmary, the University of...
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Baltimore, MD
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