Drug & supplement interaction

Apple + Metolazone

Metolazone brand names: Diulo, Zaroxolyn, Mykrox.

Moderate Interaction
The bottom line Moderate

Apple has a moderate interaction with Metolazone. Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Apple and Metolazone

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ANTIHYPERTENSIVE DRUGS

Why this applies to Metolazone

Metolazone falls under ANTIHYPERTENSIVE DRUGS — the group Apple interacts with.

Consuming apple juice with antihypertensive drugs might interfere with blood pressure control.
Some clinical evidence suggests that consuming apple and cherry juice can increase blood pressure in elderly patients.
Severity Moderate Likelihood Probable Evidence B

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the practical takeaway for metolazone: this is a water pill you take to lower blood pressure and clear extra fluid. Some lower-quality research suggests that drinking a lot of apple juice (and cherry juice) may nudge blood pressure upward in older adults, which could work against what your metolazone is trying to do. The concern is about your blood pressure control, not about apple changing how the drug is broken down.

A whole apple eaten as a snack is unlikely to be a problem. Larger amounts of apple juice are where this might matter. If you notice your readings creeping up, don't stop your metolazone. Just mention your juice habits to your pharmacist or doctor so they can keep an eye on your numbers.

References
  1. Visvanathan, R., Chen, R., Horowitz, M., and Chapman, I. Blood pressure responses in healthy older people to 50 g carbohydrate drinks with differing glycaemic effects. Br J Nutr 2004;92(2):335-340. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Apple Also Interacts With Other Medications

Apple has 47 major, 252 moderate known drug interactions in our database — the Metolazone one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Apple

Covers the 2,830 medications we’ve checked against Apple. Pick one to open its full report.

From our Q&A

Questions About Apple or Metolazone

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Apple or Metolazone, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Metolazone

This page covers Apple only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Metolazone page lists 222 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Dolomite (major) and Lithium (major).

By severity: 8 major · 190 moderate · 24 minor.

Open the Metolazone interaction page

One more smart check

Taking Apple as Part of a Dietary Supplement Product? Check It for Interactions

We hold 2,841 real supplement products containing Apple, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Apple. Your product may carry other ingredients that interact with Metolazone too, on top of Apple — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Apple and Metolazone Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Apple
Top 10%

#107 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Metolazone
Steady interest

#1,771 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Apple

What is Apple?

Apple
  • General nutrition and fiber intake
  • Heart and cholesterol health
  • Blood sugar and weight management
  • Digestive regularity
  • Antioxidant support

Apples are a nutritious whole food that provides fiber, vitamins, and antioxidant plant compounds, and eating them regularly fits well into a healthy diet. While research suggests apples may support heart and digestive health, most claims about concentrated apple supplements or extracts are not strongly proven, so enjoy apples as food and talk with your pharmacist before using high-dose products.

Read the full Apple monograph & all interactions
Medication

About Metolazone

What Is Metolazone Used For?

Brand names: Diulo, Zaroxolyn, Mykrox

Metolazone tablets are used to treat edema (excess fluid buildup) linked to congestive heart failure or kidney diseases — including nephrotic syndrome and conditions with reduced kidney function. They are also used to treat high blood pressure (hypertension), either alone or alongside other blood pressure medications.

Metolazone tablets may also be used during pregnancy when edema is caused by a medical condition rather than normal pregnancy changes — but routine use in otherwise healthy pregnant women is not appropriate.

See full Metolazone drug information
Keep checking

Other Drugs & Apple

Browse every other medication we’ve checked against Apple — both the ones with a known interaction and the ones without. Select any drug for the full detail.

47Major
252Moderate
0Minor
2,530No known interaction
Major

47 interactions

Moderate

252 interactions

Showing 60 of 252 moderate interactions — see all 252 on the Apple page.

No interaction 2,530 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Apple and Metolazone Together: Common Questions

Can you take Apple with Metolazone?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Apple and Metolazone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Metolazone and Apple?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.