Ziac

Pronunciation: BIS-oh-PROE-lol/HYE-droe-KLOR-oh-THYE-a-zide
Generic Name: Bisoprolol/Hydrochlorothiazide
Brand Name: Ziac

Ziac is used for:

Treating high blood pressure.

Ziac is a beta-blocker and diuretic combination. The beta-blocker works by slowing down the heartbeat, helping the heart beat more regularly, and reducing the amount of work the heart has to do. The diuretic increases the elimination of excess fluid, which helps to decrease blood pressure.

Do NOT use Ziac if:

• you are allergic to any ingredient in Ziac or to a sulfonamide medicine (eg, sulfamethoxazole, probenecid, glyburide)


• you have uncontrolled heart failure, heart block, a very slow heart rate, or shock caused by serious heart problems


• you are unable to urinate


• you are taking another beta-blocker (eg, propranolol), dofetilide, or mibefradil

Contact your doctor or health care provider right away if any of these apply to you.

Before using Ziac:

Some medical conditions may interact with Ziac. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have asthma, bronchitis, lung disease (eg, chronic obstructive pulmonary disease [COPD]), diabetes, gout, an overactive thyroid, low blood levels of potassium or sodium, blood vessel or circulation problems, an adrenal gland tumor (pheochromocytoma), lupus, liver disease, or kidney problems


• if you have low blood pressure or a history of chest pain or angina, heart attack, slow or irregular heartbeat, or other heart problems (eg, heart failure)


• if you will be having surgery or receiving anesthesia


• if you have recently had a certain type of nerve surgery (sympathectomy)

Some MEDICINES MAY INTERACT with Ziac. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Antiarrhythmics (eg, disopyramide, flecainide), calcium channel blockers (eg, verapamil, diltiazem), cimetidine, digoxin, fingolimod, or other medicines for blood pressure because side effects, such as slow or irregular heart beat or low blood pressure, may occur


• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), barbiturates (eg, phenobarbital), diazoxide, mefloquine, mibefradil, narcotics (eg, codeine), or nifedipine because the actions and side effects of Ziac and these medicines may be increased


• Adrenocorticotropic hormone (ACTH), other beta-blockers (eg, propranolol), corticosteroids (eg, prednisone), guanethidine, or reserpine because they may increase the risk of Ziac's side effects


• Cholestyramine, colestipol, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), or rifamycins (eg, rifampin) because they may decrease Ziac's effectiveness


• Allopurinol, amantadine, dofetilide, insulin or other medicines for diabetes (eg, glyburide), ketanserin, or lithium because their actions and the risk of their side effects may be increased


• Clonidine because stopping it or Ziac suddenly can lead to a rapid increase in blood pressure

This may not be a complete list of all interactions that may occur. Ask your health care provider if Ziac may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Ziac:

Use Ziac as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Ziac by mouth with or without food.


• If you also take cholestyramine or colestipol, ask your doctor or pharmacist how to take it with Ziac.


• Ziac may increase the amount of urine or cause you to urinate more often when you first start taking it. To keep this from disturbing your sleep, try to take your dose before 6 pm.


• Take Ziac on a regular schedule to get the most benefit from it.


• Continue to take Ziac even if you feel well. Do not miss any doses.


• If you miss a dose of Ziac, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Ziac.

Important safety information:

• Ziac may cause dizziness or light-headedness. These effects may be worse if you take it with alcohol or certain medicines. Use Ziac with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Ziac may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Drink plenty of fluids while taking Ziac and avoid engaging in activities that cause excessive sweating. Dehydration, excessive sweating, vomiting, or diarrhea may lead to a fall in blood pressure. Contact your health care provider at once if any of these occur.


• Ziac may decrease the amount of potassium in your body. If your doctor has also prescribed a potassium supplement for you, follow the dosing directions carefully. Check with your doctor before taking additional potassium on your own or including foods high in potassium (eg, bananas, orange juice) in your diet.


• Patients who take medicine for high blood pressure often feel tired or run down for a few weeks after starting treatment. Be sure to take your medicine even if you may not feel "normal." Tell your doctor if you develop any new symptoms.


• Ziac contains a sulfonamide called hydrochlorothiazide, which can cause certain eye problems (myopia, angle-closure glaucoma). Your risk may be increased if you are allergic to sulfonamide medicines (eg, sulfamethoxazole) or to penicillin antibiotics (eg, amoxicillin). Untreated angle-closure glaucoma can lead to permanent vision loss. If these eye problems occur, symptoms usually occur within hours to weeks of starting Ziac. Contact your doctor immediately if you experience symptoms such as vision changes (eg, decreased vision clearness) or eye pain.


• Do not suddenly stop taking Ziac. Sharp chest pain, irregular heartbeat, and sometimes heart attack may occur if you suddenly stop taking Ziac. The risk may be greater if you have certain types of heart disease. Your doctor should slowly lower your dose. When stopping treatment with Ziac, your doctor will need to slowly decrease your dose over a period of 1 to 2 weeks and will watch you closely for side effects. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking Ziac again. Because heart artery disease is common and you may not know you have it, it may be safer not to stop Ziac quickly even if you are only being treated for high blood pressure.


• Ziac may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Ziac. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


• Tell your doctor or dentist that you take Ziac before you receive any medical or dental care, emergency care, or surgery.


• If you have high blood pressure, do not use nonprescription products that contain stimulants. These products may include diet pills or cold medicines. Contact your doctor if you have any questions or concerns.


• Diabetes patients - Ziac may hide signs of low blood sugar, such as a rapid heartbeat. Be sure to watch for other signs of low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.


• If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk of an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are taking Ziac.


• Ziac may interfere with certain lab tests, including parathyroid function. Be sure your doctor and lab personnel know you are taking Ziac.


• Lab tests, including blood pressure, heart rate, and blood electrolytes, may be performed while you use Ziac. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Ziac with caution in the ELDERLY; they may be more sensitive to its effects.


• Ziac should be used with extreme caution in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: It is not known if Ziac can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Ziac while you are pregnant. Ziac is found in breast milk. Do not breast-feed while taking Ziac.

Possible side effects of Ziac:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Diarrhea; dizziness; headache; light-headedness; tiredness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; unusual hoarseness); chest pain; chills, fever, or sore throat; cold hands or feet; decreased urination; drowsiness; dry mouth or eyes; eye pain; fainting; mood or mental changes (eg, anxiety, decreased concentration, decreased memory, depression, hallucinations); muscle pain, cramps, or weakness; nausea; red, swollen, blistered, or peeling skin; restlessness; ringing in the ears or decreased hearing; severe or persistent dizziness or light-headedness; severe or persistent stomach pain; shortness of breath; slow, fast, or irregular heartbeat; sudden, unexplained weight gain; swelling of the hands, ankles, or feet; symptoms of low blood sodium levels (eg, confusion, seizures, sluggishness); unusual bruising or bleeding; unusual thirst, weakness, or fatigue; vision changes (eg, blurred vision, decreased vision clearness); vomiting; wheezing; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Ziac side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include fainting; loss of consciousness; severe dizziness or light-headedness; slow heart rate; symptoms of blood electrolyte problems (eg, confusion; irregular heartbeat; mental or mood changes; muscle pain, weakness, or cramping; seizures; sluggishness); symptoms of dehydration (eg, drowsiness; dry mouth or eyes; fast heartbeat; nausea or vomiting; unusual thirst, weakness, or fatigue); trouble breathing.

Proper storage of Ziac:

Store Ziac at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Ziac out of the reach of children and away from pets.

General information:

• If you have any questions about Ziac, please talk with your doctor, pharmacist, or other health care provider.


• Ziac is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Ziac. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Ziac resources

• Ziac Side Effects (in more detail)
• Ziac Use in Pregnancy & Breastfeeding
• Drug Images
• Ziac Drug Interactions
• Ziac Support Group
• 10 Reviews for Ziac - Add your own review/rating

• Ziac Prescribing Information (FDA)


• Ziac Advanced Consumer (Micromedex) - Includes Dosage Information


• Ziac Consumer Overview

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