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- What is bisoprolol and hydrochlorothiazide, and how does it work (mechanism of action)?
- What are the uses 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 brand names are available for bisoprolol and hydrochlorothiazide?
Is bisoprolol and hydrochlorothiazide available as a generic drug?
GENERIC AVAILABLE: Yes
Do I need a prescription for bisoprolol and hydrochlorothiazide?
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:
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.
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.
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Bisoprolol and hydrochlorothiazide (Ziac) is a drug prescribed for the treatment of high blood pressure and angina. Review side effects, drug interactions, dosing, and pregnancy safety information prior to taking this medication.
Related Disease Conditions
Angina 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.
High Blood Pressure (Hypertension) Signs, Causes, Diet, and Treatment
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 Treatment (Natural Home Remedies, Diet, Medications)
High 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.
Treatment & Diagnosis
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Medications & Supplements
- timolol (Betimol)
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- bisoprolol (Zebeta)
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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.