Drug & supplement interaction

Cesium + Metolazone

Metolazone brand names: Diulo, Zaroxolyn, Mykrox.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Cesium has a moderate interaction with Metolazone. Theoretically, taking cesium concomitantly with other drugs that deplete potassium, such as diuretics, may increase the risk of hypokalemia.

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

Cesium and Metolazone

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

Moderate

DIURETIC DRUGS

Why this applies to Metolazone

Metolazone falls under DIURETIC DRUGS — the group Cesium interacts with.

Theoretically, taking cesium concomitantly with other drugs that deplete potassium, such as diuretics, may increase the risk of hypokalemia.
Cesium supplements have been associated with hypokalemia in many case reports.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

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

Here's the concern with these two together. Metolazone is a water pill that makes you pee out extra fluid and salt, and one well-known side effect is that it also lowers your potassium. Cesium chloride has separately been tied to low potassium in a number of case reports. Stack them up and you could push your potassium even lower than the metolazone alone would.

Low potassium isn't trivial. It can cause muscle cramps, weakness, fatigue, and dangerous heart rhythm problems, and cesium itself is already notorious for triggering serious heart rhythm trouble. Honestly, cesium has no proven benefit and real risks, so I'd steer clear of it entirely. Please talk with your doctor or pharmacist before mixing anything with your metolazone.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Sartori HE. Nutrients and cancer: an introduction to cesium therapy. Pharmacol Biochem Behav 1984;21:7-10. PubMed
  2. Neulieb R. Effect of oral intake of cesium chloride: a single case report. Pharmacol Biochem Behav 1984;21:15-6.
  3. Lyon AW, Mayhew WJ. Cesium toxicity: A case of self-treatment by alternate therapy gone awry. Ther Drug Monit 2003;25:114-6. PubMed
  4. FDA alerts health care professionals of significant safety risks associated with cesium chloride. FDA: Human Drug Compounding. July 23,2018. Available at: https://www.fda.gov/drugs/human-drug-compounding/fda-alerts-health-care-professionals-significant-sa
  5. Public Health Alert Concerning Dietary Supplements Containing Cesium Salts. FDA Dietary Supplement Products & Ingredients. February 5, 2020. Available at: https://www.fda.gov/food/dietary-supplement-products-ingredients/public-health-alert-concerning-diet

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

Cesium Also Interacts With Other Medications

Cesium has 161 major, 93 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.

Major 161 Moderate 93 No known interaction 2,576 (incl. Metolazone)
Taking anything else?

Check Another of Your Medications Against Cesium

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

Everything else you take

See Every Supplement That Interacts With Metolazone

This page covers Cesium 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 Cesium as Part of a Dietary Supplement Product? Check It for Interactions

We hold 51 real supplement products containing Cesium, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cesium. Your product may carry other ingredients that interact with Metolazone too, on top of Cesium — 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 Cesium 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 Cesium
Top half

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

29 days ago today
Medication Metolazone
Top 25%

#706 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 Cesium

What is Cesium?

  • Marketed as an alternative cancer treatment ('high pH therapy')
  • Claimed to alter tumor pH
  • General 'alkaline' health claims

Cesium chloride is a mineral salt sold as an alternative cancer therapy ('high pH therapy'), but there is no reliable scientific evidence that it treats cancer or any other disease. It can cause dangerous heart rhythm problems and even death, so it should not be used. Talk to your doctor or pharmacist before taking any supplement, and never use cesium in place of proven medical care.

Read the full Cesium monograph & all interactions
Medication

About Metolazone

What Is Metolazone Used For?

Brand names: Diulo, Zaroxolyn, Mykrox

Metolazone tablets help your body get rid of extra salt and water. They are used for swelling (edema) caused by heart failure and by kidney diseases, including nephrotic syndrome and reduced kidney function.

They are also used to treat high blood pressure, either alone or with other blood pressure medicines from a different class. Mykrox tablets, a faster-acting form of metolazone, are meant for new patients with mild to moderate high blood pressure.

See full Metolazone drug information
Keep checking

Other Drugs & Cesium

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

161Major
93Moderate
0Minor
2,575No known interaction
161 Major 93 Moderate 2,575 No interaction
Major

161 interactions

Showing 60 of 161 major interactions — see all 161 on the Cesium page.

Moderate

93 interactions

Showing 60 of 93 moderate interactions — see all 93 on the Cesium page.

No interaction 2,575 drugs checked — show the list

We also checked Cesium against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,575 medications checked with no known interaction — see the full Cesium list.

See the full Cesium interactions page
See every supplement checked against Metolazone, ranked by severity
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

Keep exploring
Cesium monograph › Uses, safety, and every drug interaction in one place Metolazone supplement interactions › Every supplement checked against Metolazone, ranked by severity Metolazone drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Cesium and Metolazone Together: Common Questions

Can you take Cesium 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 Cesium 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 Cesium?

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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.