Synergistic action of metolazone with "loop" diuretics.

Sodium chloride absorption by the urinary bladder of the winter flounder. A thiazide-sensitive, electrically neutral transport system.

“…It is probably confined to the distal convoluted tubule (30-33) (and perhaps the medullary collecting tubule, reference 34) since recent evidence indicates that there is no thiazide-sensitive NaCl absorption in the cortical thick ascending limb of Henle's loop where furosemide completely inhibits transport (40). The conclusion that furosemide and thiazides inhibit two different Na(Cl) transport systems in man is supported by the reports demonstrating additive effects of these classes of diuretics (41,42).…”

Combination Therapy with Metolazone and Loop Diuretics in Outpatients with Refractory Heart Failure: An Observational Study and Review of the Literature

“…Due to the risk of excessive natriuresis resulting in volume depletion and electrolyte abnormalities, some authors recommend that combination therapy with metolazone and loop diuretics be used only in-hospital [25][26][27], but as noted, outpatient use has been reported as well [22,24]. No studies have addressed the efficacy and safety on this regimen in contemporary treatment of outpatients with refractory HF.…”

Combination diuretic treatment in severe heart failure: a randomised controlled trial.

“…Area under the body weight loss against time curves showed no significant difference between the two thiazide diuretics. Median (range) maximal weight loss after three days of treatment was -5 4 (-12.2 to 4.8) kg and -55 (-10-3 to 1) kg after a more prolonged course of median (range) [5][6] (1 to 13) days (NS). Area under the body weight loss time curves showed no significant difference between the two durations of treatment.…”