Drug General Information (ID: DDIB8T4P1J)
Drug Name			Metolazone		Drug Info		Chloral hydrate		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Anxiolytics/Sedatives/Hypnotics
Structure

Mechanism of Metolazone-Chloral hydrate Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph
Drug Name		Metolazone				Chloral hydrate
Mechanism 1		Antihypertensive agent				Antihypertensive agent
Key Mechanism Factor 1
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Metolazone and Chloral hydrate
Mechanism 2		Antihypertensive agent				Hypotensive effects
Key Mechanism Factor 2
		Factor Name		Hypotensive effects
		Factor Description		Hypotension is a blood pressure reading below the prescribed limit (90/60 mmHg). Symptoms of hypotension may include: blurred or faded vision , dizziness or light-headedness, fainting , fatigue , difficulty concentrating, nausea.
Mechanism Description		Additive hypotensive effects by the combination of Metolazone and Chloral hydrate

Recommended Action
Management		Caution and close monitoring for development of hypotension is advised during coadministration of these agents. Avoid alcohol in patients receiving vasodilating antihypertensive drugs. Patients should be advised to avoid rising abruptly from a sitting or recumbent position and to notify their physician if they experience dizziness, lightheadedness, syncope, orthostasis, or tachycardia.

References
1	Ellison JM, Milofsky JE, Ely E "Fluoxetine-induced bradycardia and syncope in two patients." J Clin Psychiatry 51 (1990): 385-6. [PMID: 2211552]
2	Feder R "Bradycardia and syncope induced by fluoxetine." J Clin Psychiatry 52 (1991): 139. [PMID: 2005082]
3	Sternbach H "Fluoxetine-associated potentiation of calcium-channel blockers." J Clin Psychopharmacol 11 (1991): 390-1. [PMID: 1770159]