Generic Name: hydrochlorothiazide and bisoprolol (HYE droe klor oh THYE a zide and bi SOE proe lol)Brand Names: Ziac
What is hydrochlorothiazide and bisoprolol?
Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.
Bisoprolol is a beta-blocker. Beta-blockers affect the heart and circulation (blood flow through arteries and veins).
The combination of hydrochlorothiazide and bisoprolol is used to treat high blood pressure (hypertension).
Hydrochlorothiazide and bisoprolol may also be used for purposes not listed in this medication guide.
What is the most important information I should know about hydrochlorothiazide and bisoprolol?You should not use this medication if you have severe or uncontrolled heart failure, a heart condition called "sick sinus syndrome" or "AV block," slow heartbeats, an allergy to sulfa drugs, or if you are unable to urinate.
Before using this medication, tell your doctor if you have congestive heart failure, circulation problems, kidney or liver disease, cirrhosis, glaucoma, asthma, bronchospastic lung disease, a thyroid disorder, lupus, gout, diabetes, or a penicillin allergy.
If you are diabetic, check your blood sugar carefully. Using bisoprolol can make it harder for you to tell when you have low blood sugar. Your insulin or diabetic medication needs may change while you are taking hydrochlorothiazide and bisoprolol. Talk with your doctor before changing any doses.Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and bisoprolol.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.Keep using this medication even if you feel fine. High blood pressure often has no symptoms.
There are many other medicines that can interact with hydrochlorothiazide and bisoprolol. Tell your doctor about all the prescription and over-the-counter medications you use.
What should I discuss with my doctor before taking hydrochlorothiazide and bisoprolol?You should not use this medication if you are allergic to hydrochlorothiazide or bisoprolol, or if you have:
severe or uncontrolled heart failure-
a heart condition called "sick sinus syndrome" or "AV block" (2nd or 3rd degree)-
if you are unable to urinate-
if you are allergic to sulfa drugs- or
if you are allergic to any beta-blocker medication, such as atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), timolol (Blocadren), and others.
To make sure you can safely take hydrochlorothiazide and bisoprolol, tell your doctor if you have any of these other conditions:
congestive heart failure-
blood circulation problems-
liver disease (or cirrhosis)-
asthma, or bronchospastic lung disease-
a thyroid disorder-
a penicillin allergy.
How should I take hydrochlorothiazide and bisoprolol?
Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.Take the medicine with a meal or right after you eat.
Your doctor may occasionally change your dose to make sure you get the best results.Do not stop using hydrochlorothiazide and bisoprolol suddenly, or you could have a serious or life-threatening heart problem. Talk to your doctor about how to avoid withdrawal symptoms when stopping the medication.
Your blood pressure will need to be checked often. Your blood and urine may both be tested if you have been vomiting or are dehydrated. Visit your doctor regularly.
If you are diabetic, check your blood sugar carefully. Using bisoprolol can make it harder for you to tell when you have low blood sugar. Your insulin or diabetic medication needs may change while you are taking hydrochlorothiazide and bisoprolol. Talk with your doctor before changing any doses.
Hydrochlorothiazide and bisoprolol can affect the results of certain thyroid tests. Tell any doctor who treats you that you are using this medication.If you need surgery, tell the surgeon ahead of time that you are using hydrochlorothiazide and bisoprolol. You may need to stop using the medicine for a short time. Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life. Store in a tightly closed container at room temperature, away from heat, moisture, and light.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include fast or slow heart rate, confusion, weakness, shallow breathing, swelling, increased urination, and feeling like you might pass out.
What should I avoid while taking hydrochlorothiazide and bisoprolol?Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and bisoprolol.
Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Hydrochlorothiazide and bisoprolol side effectsGet emergency medical help if you have any of these signs of an allergic reaction: hives- difficulty breathing- swelling of your face, lips, tongue, or throat. Stop using this medication and call your doctor at once if you have any of these serious side effects:
eye pain, vision problems-
swelling, rapid weight gain, feeling short of breath, even with mild exertion-
fast, slow, or uneven heartbeat-
easy bruising or bleeding-
sudden numbness or weakness, especially on one side of the body-
sudden severe headache, confusion, problems with speech or balance-
chest pain, sudden cough, wheezing, rapid breathing, coughing up blood-
pain, swelling, warmth, or redness in one or both legs-
numbness or tingly feeling in your hands or feet-
feeling weak, drowsy, restless, or light-headed-
dry mouth, extreme thirst, confusion, increased urination, leg discomfort, muscle weakness or limp feeling, nausea and vomiting-
urinating less than usual or not at all-
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash- or
upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
Less serious side effects may include:
diarrhea, constipation, upset stomach-
dizziness, spinning sensation-
cough, runny nose-
ringing in your ears- or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Hydrochlorothiazide and bisoprolol Dosing Information
Usual Adult Dose for Hypertension:
Initial dose: 1 tablet of (bisoprolol-hydrochlorothiazide 2.5 mg/6.25 mg) once a day. Determine dosage by individual titration.Maintenance dose: May increase up to a maximum dose of 2 tablets of (bisoprolol-hydrochlorothiazide 10 mg/6.25 mg) once a day.
What other drugs will affect hydrochlorothiazide and bisoprolol?Tell your doctor if you regularly use any other medicines that make you light-headed (especially narcotic pain medication or barbiturates). They can add to the side effects of hydrochlorothiazide and bisoprolol.
Many drugs can interact with hydrochlorothiazide and bisoprolol. Below is just a partial list. Tell your doctor if you are using:
insulin or oral diabetes medication-
colestipol (Colestid) or cholestyramine (Prevalite, Questran)-
steroids (prednisone and others)-
rifampin (Rifadin, Rifamate, Rimactane)-
NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others-
other heart or blood pressure medications such as clonidine (Catapres) or reserpine- or
a calcium channel blocker such as amlodipine (Norvasc, Caduet, Exforge, Lotrel, Tekamlo, Tribenzor, Twynsta, Amturnide), diltiazem (Cartia, Cardizem), nifedipine (Nifedical, Procardia), or verapamil (Calan, Covera, Isoptin, Verelan).
This list is not complete and other drugs may interact with hydrochlorothiazide and bisoprolol. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
Where can I get more information?
Your pharmacist can provide more information about hydrochlorothiazide and bisoprolol.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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