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- What is bisoprolol and hydrochlorothiazide, and how does it work (mechanism of action)?
- What brand names are available for bisoprolol and hydrochlorothiazide?
- Is bisoprolol and hydrochlorothiazide available as a generic drug?
- Do I need a prescription for bisoprolol and hydrochlorothiazide?
- What are the side effects of bisoprolol and hydrochlorothiazide?
- What is the dosage for bisoprolol and hydrochlorothiazide?
- Which drugs or supplements interact with bisoprolol and hydrochlorothiazide?
- Is bisoprolol and hydrochlorothiazide safe to take if I'm pregnant or breastfeeding?
- What else should I know about bisoprolol and hydrochlorothiazide?
What is bisoprolol and hydrochlorothiazide, and how does it work (mechanism of action)?
Ziac is a combination product containing bisoprolol (Zebeta) and hydrochlorothiazide (HCTZ). Bisoprolol is a beta-adrenergic receptor blocking agent used for treating high blood pressure and heart pain (angina). Bisoprolol prevents the neurotransmitters (chemicals that nerves use to communicate with other nerves), norepinephrine and epinephrine (adrenaline), from binding to beta adrenergic receptors on nerves. By blocking the effect of norepinephrine and epinephrine on the nerves reaching the heart and blood vessels, beta blockers reduce heart rate and the force with which the heart contracts and reduce blood pressure by dilating blood vessels. It also may constrict air passages by stimulating the muscles that surround the air passages. Hydrochlorothiazide (HCTZ) is a diuretic (water pill) used for treating high blood pressure (hypertension) and accumulation of fluid. It works by blocking salt and fluid reabsorption in the kidneys, causing increased urine output (diuresis). The mechanism of its action in lowering high blood pressure is not well understood. The combination of bisoprolol and HCTZ reduces blood pressure better than either drug alone. Ziac was approved in March 1993.
What are the side effects of bisoprolol and hydrochlorothiazide?
The most common side effects are:
- low potassium,
- low blood pressure,
- reduced heart rate, and
- increased blood glucose.
Serious side effects of Ziac include:
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What is the dosage for bisoprolol and hydrochlorothiazide?
The dose of Ziac is tailored to the patient's needs. The initial dose is 2.5/6.25 mg daily. The dose may be increased very two weeks and the maximum dose is 20/12.5 mg once daily.
Which drugs or supplements interact with bisoprolol and hydrochlorothiazide?
Rifampin may increase the metabolism (destruction) of bisoprolol, possibly making bisoprolol less effective. Certain calcium channel blockers (CCBs), especially verapamil (Calan, Isoptin) and diltiazem (Cardizem, Tiazac), may enhance the effect of bisoprolol on the heart. In some patients, this may cause excessive slowing of the heart rate or reduce the heart's ability to beat. The use of digoxin (Lanoxin) with bisoprolol also may cause an excessive reduction in heart rate.
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%.
Is bisoprolol and hydrochlorothiazide safe to take if I'm pregnant or breastfeeding?
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.
Thiazides are secreted in breast milk. It is not known whether bisoprolol is secreted in breast milk.
What else should I know about bisoprolol and hydrochlorothiazide?
What preparations of bisoprolol and hydrochlorothiazide are available?
Tablets (bisoprolol/hydrochlorothiazide): 2.5/6.25 mg, 5/6.25 mg, and 10/6.25 mg.
How should I keep bisoprolol and hydrochlorothiazide stored?
Ziac should be stored at room temperature, 59 F - 86 F (15 C - 30 C) in a tight container.
Bisoprolol and hydrochlorothiazide (Ziac) is a drug prescribed for the treatment of high blood pressure and angina. Side effects, drug interactions, dosing, and pregnancy safety information should be reviewed prior to taking this medication.
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Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Top bisoprolol and hydrochlorothiazide Related Articles
Angina SymptomsAngina is chest pain due to inadequate blood supply to the heart. Angina symptoms may include chest tightness, burning, squeezing, and aching. Coronary artery disease is the main cause of angina but there are other causes. Angina is diagnosed by taking the patient's medical history and performing tests such as an electrocardiogram (EKG), blood test, stress test, echocardiogram, cardiac CT scan, and heart catheterization. Treatment of angina usually includes lifestyle modification, medication, and sometimes, surgery. The risk of angina can be reduced by following a heart healthy lifestyle.
atenololAtenolol (Tenormin)is a beta-adrenergic blocking agent, blocking the action of the sympathetic nervous system, a portion of the involuntary nervous system. Atenolol is prescribed for patients with high blood pressure (hypertension), used to treat chest pain (angina pectoris) related to coronary artery disease, and is also useful in slowing and regulating certain types of abnormally rapid heart rates (tachycardias). Other uses for atenolol include the prevention of migraine headaches and the treatment of certain types of tremors (familial or hereditary essential tremors). It is important to be aware of the drug interactions related to atenolol, effects on pregnancy, as well as common side effects on the user.
Beta blockers are a class of drugs that block beta-adrenergic substances such as adrenaline (epinephrine), a key agent in the "sympathetic" portion of the autonomic (involuntary) nervous system and activation of heart muscle. By blocking the action of the involuntary nervous system on the heart, beta blockers relieve stress on the heart.
Beta blockers are used for the treatment of irregular heart rhythms, chest pain, heart attack, hypertension, migraine headaches, social phobias, tremors, and glaucoma.
Common side effects of beta blockers are nausea, vomiting, abdominal cramps, diarrhea, and weight gain if you are taking medicine for diabetes (type 1 and type 2). There are other important side effects and serious adverse effects of this drug class that include, blurred vision, insomnia, hair loss, disorientation, CNS system effects, and serious heart problems.
Beta blockers interact with several other drugs, for example, chlorpromazine (Thorazine), clonidine (Catapres), Phenobarbital, nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, and diabetes medications, including insulin.
Examples of generic and brand names available for beta blockers in the US include acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), metoprolol (Lopressor, Lopressor LA, Toprol XL), nadolol (Corgard), timolol (Blocadren). Talk with your doctor, pharmacist, or other medical professional if you have questions about beta-blockers.
If you notice other effects not listed above, contact your doctor or pharmacist. In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
bisoprololbisoprolol (Zebeta) is a medication in the class of drugs called beta blockers. Bisoprolol (Zebeta) is prescribed for the treatment of high blood pressure, angina, and congestive heart failure. Side effects, warnings and precautions, drug interactions, and patient information should be reviewed prior to taking any medication.
Drug InteractionsDrug interactions occur frequently. Get facts about the types of drug interactions, what substances or other things that may interact with drugs such as OTC drug and prescription drugs, vitamins, food(s) (grapefruit), and laboratory tests. Find out how to protect yourself from potential drug interactions.
Drugs: What You Should Know About Your DrugsImportant information about your drugs should be reviewed prior to taking any prescription drug. Side effects, drug interactions, warnings and precauctions, dosage, what the drug is used for, what to do if you miss a dose, how the drug is to be stored, and generic vs. brand names.
High Blood Pressure Hypertension
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms.
Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure.
The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater.
If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.
REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
High Blood Pressure TreatmentHigh blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
metoprololMetoprolol (Lopressor, Toprol XL) is a beta-adrenergic blocking agent drug, which blocks the action of the sympathetic nervous system (a portion of the involuntary nervous system). Metoprolol is prescribed to treat high blood pressure (hypertension), heart pain (angina), heart rhythm disorders, and some neurological conditions. Side effects include fever, impotence, sore throat, nausea, depression, insomnia, constipation, memory loss, and high blood pressure.
Drug interactions, dosing, and pregnancy and breastfeeding safety should be reviewed prior to taking any medication.
nadololNadolol (Corgard) is in the drug class of beta blockers and is prescribed for the treatment of angina (heart pain, chest pain), high blood pressure, abnormal heart rhythms, tremor, and the prevention of headaches and anxiety. Side effects, drug interactions, warnings and precautions, and safety during pregnancy information should be reviewed prior to taking this medication.
ParathyroidectomyParathyroidectomy is the removal of one or more of the parathyroid glands to treat hyperparathyroidism. Risks of parathyroidectomy include:
- paralysis of the vocal cords,
- difficulty swallowing thin liquids,
- difficulty breathing,
- and drug reactions.
- damage to the recurrent laryngeal nerve,
- bleeding or hematoma,
- problems maintaining calcium levels in the blood,
- need for further and more aggressive surgery,
- need for a limited or total thyroidectomy,
- prolonged pain,
- impaired healing,
- and recurrence of the tumor.
Timolol (Blocadren and Timolide 10-25 brand names have been discontinued) is a first generation beta blocker drug. Timolol is prescribed for the treatment of high blood pressure, angina, heart attacks, and migraine headache prevention. Off label uses include treatment for cardiomyopathy and mitral valve prolapse. Side effects include:
- Abdominal cramps
Drug interactions, warnings and precautions, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication.