Diuretic Effect of Metolazone Pre-dosing Versus Concurrent Dosing

Phase

Condition

Chest Pain

Congestive Heart Failure

Heart Failure

Treatment

N/A

Clinical Study ID

NCT03746002

HP-00082982

Ages 18-89
All Genders

Study Summary

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.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Admission within 48 hours for acute decompensated heart failure with at least onesymptom 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 hourswith additional diuresis deemed necessary
If patient is concurrently administered intravenous vasodilator or inotrope, the doseof vasodilator or inotrope must be stable for 6 hours prior to enrollment with a planto continue the same dose for the 24 hour duration of this study

Exclusion

Exclusion Criteria:

Metolazone prescribed prior to admission
Receipt of continuous intravenous infusion of furosemide
Cirrhosis or end stage renal disease
Non-English speaking patients

Study Design

January 01, 2019

January 10, 2020

Study Description

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.

Connect with a study center

University of Maryland Medical Center
Baltimore, Maryland 21201
United States
Site Not Available

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