Hydrochlorothiazide reduces the elimination of lithium (Lithobid, Eskalith) by the kidneys and can lead to lithium toxicity. Nonsteroidal anti-inflammatory drugs, for example, ibuprofen, may reduce the blood pressure effects of hydrochlorothiazide.
Combining HCTZ with corticosteroids may increase the risk for low levels of blood potassium and other electrolytes. Low blood potassium can increase the toxicity of digoxin (Lanoxin). Cholestyramine (Questran, Questran Light) and colestipol (Colestid) bind to hydrochlorothiazide and reduce its absorption from the gastrointestinal tract by 43%-85%.
PREGNANCY: There is no information about the effects of ZIAC on the fetus in pregnant women. Physicians may elect to use Ziac if its benefits are deemed to outweigh potential risks.
NURSING MOTHERS: Thiazides are secreted in breast milk. It is not known whether bisoprolol is secreted in breast milk.
Medically reviewed by Eni Williams, PharmD
Reference: FDA Prescribing Information
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