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AMR Drug RepurposingSmart Screeningresearch prototype

Metolazone

FDA-approved product (tablet, oral), marketed as Diulo, Metolazone, Mykrox and 1 more.

Registered studies
36
Lab records
0
Pathogens at ≥40%
2 of 4

Chemical structure

Chemical structure of Metolazone
A drawing shows what the molecule is, not what it does.

Existing / approved use

Documented · FDA, WHO, ChEMBL

Approved for

  • Cardiovascular disease
  • Congestive heart failure
  • Heart failure
  • Hypertension
  • Preeclampsia

Indications ChEMBL records as approved, from FDA and DailyMed labels. Label ↗

WHO therapeutic group
Sulfonamides, plain
FDA pharmacologic class
Thiazide-like Diuretic FDA label ↗
Anti-infective classification
Not classified as an anti-infective.

Repurposing investigation

This medicine is being investigated here for AI-predicted antimicrobial activity against M. tuberculosis and MRSA. It was surfaced computationally for further investigation; it is not an established treatment for these infections.

AI-predicted activity

AI prediction · nothing measured
  • MRSA42.2% AI-predicted activityAt or above the ≥40% mark this site uses to surface candidates.
  • E. coli31.3% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.
  • K. pneumoniae26.6% AI-predicted activityBelow the ≥40% mark this site uses to surface candidates.
  • M. tuberculosis59.0% AI-predicted activityAt or above the ≥40% mark this site uses to surface candidates.

A model’s estimate of laboratory activity against each pathogen species. It is not clinical effectiveness.

Evidence

Clinical and experimental

Documented evidence

Clinical

36registered studies name this medicine, for any condition. See them below.

Experimental

No evidence found

No laboratory measurement against the four pathogens in the ChEMBL records loaded here.

Open Metolazone in ChEMBL Registered studies below

Docking

Computational · nothing measured

Dihydrofolate reductase ↗ (E. coli)

-8.0 kcal/mol

0better fit →-12

KPC-2 carbapenemase ↗ (K. pneumoniae)

-8.0 kcal/mol

0better fit →-12

Enoyl-ACP reductase (InhA) ↗ (M. tuberculosis)

-7.7 kcal/mol

0better fit →-12

Dihydrofolate reductase ↗ (MRSA)

-7.4 kcal/mol

0better fit →-12

AutoDock Vina, one experimentally solved protein per pathogen. This project’s screening target is -7.0 kcal/mol, its own mark rather than a universal cutoff. A docking score is a structural hypothesis, not proof of binding, and requires experimental validation.

Other medicines to investigate

AI prediction · nothing measured

Other repurposing candidates: approved medicines besides Metolazone with AI-predicted activity ≥40% against the chosen pathogen, leaving out existing antimicrobials. They are computational candidates for further investigation, not alternatives and not recommendations.

Sorted by AI-predicted activity, high to low. The order is not a ranking of which medicine is better.

Registered studies

A registration describes a study; it does not establish a positive result.

  • Add-on Diuretics in Acute Decompensated Heart Failure

    NCT07372040 · start 2026-02-01

    Registered record
    Registry ID
    NCT07372040
    Conditions
    Acute Decompensated Heart Failure
    Interventions
    empagliflozin; Acetazolamide; metolazone
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Recruiting
    Start
    2026-02-01
    Completion
    2027-02-01
    Enrolment
    66

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute Decompensated Heart Failure
    Interventionempagliflozin; Acetazolamide; metolazone
    PhasePhase 2
    Registry statusRecruiting

  • Comparative Efficacy and Safety of Acetazolamide Versus Metolazone as an Adjunct to Standard Therapy in Patients With Acute Decompensated Heart Failure

    NCT07199088 · start 2025-10-11

    Registered record
    Registry ID
    NCT07199088
    Conditions
    Acute Decompensated Heart Failure; Heart Failure, Diastolic; Heart Failure, Systolic
    Interventions
    Acetazolamide; Metolazone
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Recruiting
    Start
    2025-10-11
    Completion
    2026-10-30
    Enrolment
    320

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute Decompensated Heart Failure; Heart Failure, Diastolic; Heart Failure, Systolic
    InterventionAcetazolamide; Metolazone
    PhaseNot applicable
    Registry statusRecruiting

  • Optimal Diuretic Therapies for Acute Heart Failure With Volume Overload

    NCT06166654 · start 2024-09-05

    Registered record
    Registry ID
    NCT06166654
    Conditions
    Acute Heart Failure
    Interventions
    Acetazolamide; Metolazone 2.5 MG; Double-placebo
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Recruiting
    Start
    2024-09-05
    Completion
    2027-12-30
    Enrolment
    939

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute Heart Failure
    InterventionAcetazolamide; Metolazone 2.5 MG; Double-placebo
    PhasePhase 4
    Registry statusRecruiting

  • Efficacy and Safety of Combination Diuretic Therapy in Patients With Acute Decompensated Heart Failure and Volume Overload

    NCT06414759 · start 2024-07-01

    Registered record
    Registry ID
    NCT06414759
    Conditions
    Acute Decompensated Heart Failure; Volume Overload; Edema
    Interventions
    Acetazolamide; Metolazone; IV Loop Diuretics
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Unknown
    Start
    2024-07-01
    Completion
    2025-03-30
    Enrolment
    110

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute Decompensated Heart Failure; Volume Overload; Edema
    InterventionAcetazolamide; Metolazone; IV Loop Diuretics
    PhasePhase 4
    Registry statusUnknown

  • Acetazolamide or Metolazone in Acute Heart Failure

    NCT06273397 · start 2024-05-01

    Registered record
    Registry ID
    NCT06273397
    Conditions
    Heart Failure Acute; Decompensated Heart Failure
    Interventions
    Acetazolamide 250 MG; Metolazone 2.5 MG; Furosemide Injection
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Not yet recruiting
    Start
    2024-05-01
    Completion
    2027-05-01
    Enrolment
    1,050

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHeart Failure Acute; Decompensated Heart Failure
    InterventionAcetazolamide 250 MG; Metolazone 2.5 MG; Furosemide Injection
    PhaseNot applicable
    Registry statusNot yet recruiting

  • Role of Active Deresuscitation After Resuscitation:

    NCT06326112 · start 2024-05-01

    Registered record
    Registry ID
    NCT06326112
    Conditions
    Fluid Overload; Critical Illness; Sepsis; ARDS; Trauma
    Interventions
    Furosemide Injection; Metolazone Tablets
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Unknown
    Start
    2024-05-01
    Completion
    2025-06-30
    Enrolment
    120

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionFluid Overload; Critical Illness; Sepsis; ARDS +1 more
    InterventionFurosemide Injection; Metolazone Tablets
    PhasePhase 2
    Registry statusUnknown

  • Diuretic Strategies in Acute Heart Failure Patients at High Risk for Diuretic Resistance

    NCT05986773 · start 2023-10-10

    Registered record
    Registry ID
    NCT05986773
    Conditions
    Acute Heart Failure; Diuretic Resistance
    Interventions
    Furosemide; Metolazone; Acetazolamide
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Terminated
    Start
    2023-10-10
    Completion
    2024-12-31
    Enrolment
    13

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionAcute Heart Failure; Diuretic Resistance
    InterventionFurosemide; Metolazone; Acetazolamide
    PhasePhase 4
    Registry statusTerminated

  • The Heart Failure Diuresis Efficacy Comparison (DEA-HF) Study

    NCT05904808 · start 2023-04-19

    Registered record
    Registry ID
    NCT05904808
    Conditions
    Chronic Heart Failure; Diuretics Drug Reactions; Congestive Heart Failure
    Interventions
    IV Furosemide; IV Furosemide and PO Metolazone; IV Furosemide and IV Acetazolamide
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Completed
    Start
    2023-04-19
    Completion
    2023-08-24
    Enrolment
    42

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionChronic Heart Failure; Diuretics Drug Reactions; Congestive Heart Failure
    InterventionIV Furosemide; IV Furosemide and PO Metolazone; IV Furosemide and IV Acetazolamide
    PhasePhase 4
    Registry statusCompleted

  • Systematic Escalation of diuREtics With Natriuresis in Heart Failure Patients: SERENA Trial

    NCT04907123 · start 2021-10

    Registered record
    Registry ID
    NCT04907123
    Conditions
    Heart Failure
    Interventions
    Intensive sodiuria-guided diuretic treatment; Standard diuretic treatment
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Unknown
    Start
    2021-10
    Completion
    2025-01
    Enrolment
    198

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHeart Failure
    InterventionIntensive sodiuria-guided diuretic treatment; Standard diuretic treatment
    PhasePhase 3
    Registry statusUnknown

  • Diuretics vs. Afterload Reduction for Treatment of HeartLogic Alerts

    NCT06218199 · start 2021-07-08

    Registered record
    Registry ID
    NCT06218199
    Conditions
    Heart Failure, Congestive
    Interventions
    Furosemide; Torsemide; Bumetanide; sacubitril/valsartan; Hydralazine; Isosorbide Dinitrate
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Recruiting
    Start
    2021-07-08
    Completion
    2026-12-31
    Enrolment
    80

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHeart Failure, Congestive
    InterventionFurosemide; Torsemide; Bumetanide; sacubitril/valsartan +2 more
    PhasePhase 4
    Registry statusRecruiting

  • Aquapheresis Efficacy in Outpatients With Decompensated Heart Failure

    NCT04572867 · start 2021-06-08

    Registered record
    Registry ID
    NCT04572867
    Conditions
    Heart Failure; Congestive Heart Failure; Decompensated Heart Failure
    Interventions
    Aquapheresis; IV Diuretics
    Study type
    INTERVENTIONAL
    Phase
    Not applicable
    Registry status
    Withdrawn
    Start
    2021-06-08
    Completion
    2021-07-27
    Enrolment
    0

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHeart Failure; Congestive Heart Failure; Decompensated Heart Failure
    InterventionAquapheresis; IV Diuretics
    PhaseNot applicable
    Registry statusWithdrawn

  • DAPAgliflozin Versus Thiazide Diuretic in Patients With Heart Failure and Diuretic RESISTance

    NCT04860011 · start 2021-04-27

    Registered record
    Registry ID
    NCT04860011
    Conditions
    Heart Failure
    Interventions
    Dapagliflozin 10 MG Oral Tablet; Metolazone Tablets
    Study type
    INTERVENTIONAL
    Phase
    Phase 3
    Registry status
    Unknown
    Start
    2021-04-27
    Completion
    2023-04-03
    Enrolment
    61

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHeart Failure
    InterventionDapagliflozin 10 MG Oral Tablet; Metolazone Tablets
    PhasePhase 3
    Registry statusUnknown

  • Ertugliflozin in Chronic Heart Failure

    NCT04438213 · start 2021-03-10

    Registered record
    Registry ID
    NCT04438213
    Conditions
    Heart Failure
    Interventions
    Ertugliflozin; Metolazone; Placebo
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Recruiting
    Start
    2021-03-10
    Completion
    2025-12-30
    Enrolment
    60

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHeart Failure
    InterventionErtugliflozin; Metolazone; Placebo
    PhasePhase 2
    Registry statusRecruiting

  • Efficacy of Diuretics in Kidney Disease

    NCT04542304 · start 2021-03-01

    Registered record
    Registry ID
    NCT04542304
    Conditions
    Chronic Kidney Disease; End Stage Renal Disease
    Interventions
    Metolazone; Placebo
    Study type
    INTERVENTIONAL
    Phase
    Phase 2
    Registry status
    Terminated
    Start
    2021-03-01
    Completion
    2023-06-15
    Enrolment
    17

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionChronic Kidney Disease; End Stage Renal Disease
    InterventionMetolazone; Placebo
    PhasePhase 2
    Registry statusTerminated

  • Coronavirus (COVID-19) ACEi/ARB Investigation

    NCT04330300 · start 2020-04-30

    Registered record
    Registry ID
    NCT04330300
    Conditions
    Hypertension; COVID-19
    Interventions
    Thiazide or Thiazide-like diuretics; Calcium Channel Blockers; ACE inhibitor; Angiotensin receptor blocker
    Study type
    INTERVENTIONAL
    Phase
    Phase 4
    Registry status
    Suspended
    Start
    2020-04-30
    Completion
    2021-12-01
    Enrolment
    2,414

    As stored from ClinicalTrials.gov. Registration describes a study; it does not mean the study worked.

    ConditionHypertension; COVID-19
    InterventionThiazide or Thiazide-like diuretics; Calcium Channel Blockers; ACE inhibitor; Angiotensin receptor blocker
    PhasePhase 4
    Registry statusSuspended