Ziac

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What is Ziac?


Ziac is a medication comprising a combination of hydrochlorothiazide and bisoprolol. Hydrochlorothiazide functions as a thiazide diuretic, commonly known as a water pill, while bisoprolol is classified as a beta-blocker. Ziac is primarily prescribed for the treatment of high blood pressure (hypertension).

Tablet Strengths


Ziac tablets are available in three different strengths:

  • 2.5 mg/6.25 mg (bisoprolol fumarate 2.5 mg and hydrochlorothiazide 6.25 mg)
  • 5 mg/6.25 mg (bisoprolol fumarate 5 mg and hydrochlorothiazide 6.25 mg)
  • 10 mg/6.25 mg (bisoprolol fumarate 10 mg and hydrochlorothiazide 6.25 mg)

Warnings

  • Do not use Ziac if unable to urinate or if diagnosed with severe heart conditions such as “sick sinus syndrome” or “AV block,” severe heart failure, or slow heartbeats resulting in fainting.
  • Before using Ziac, disclose any history of congestive heart failure, circulation issues, kidney or liver disease, cirrhosis, glaucoma, asthma, bronchospastic lung disease, thyroid disorder, lupus, gout, diabetes, or penicillin allergy.
  • Diabetics should monitor blood sugar levels diligently, as bisoprolol may obscure signs of low blood sugar. Adjustments to insulin or diabetic medication may be necessary, requiring consultation with a doctor.
  • Exercise caution to prevent dehydration during physical activity or in hot weather, following your doctor’s liquid intake recommendations.

Before Taking this Medicine

  • Avoid Ziac if allergic to hydrochlorothiazide or bisoprolol or if experiencing:
  • Severe or uncontrolled heart failure
  • Slow heartbeats leading to fainting
  • “Sick sinus syndrome” or “AV block” (2nd or 3rd degree)
  • Sulfa drug allergy
  • Inability to urinate
  • Inform your doctor about any existing conditions, including congestive heart failure, asthma, diabetes, thyroid disorder, glaucoma, peripheral vascular disease, kidney disease, liver disease or cirrhosis, lupus, gout, or allergies to sulfa drugs or penicillin.
  • The impact of Ziac on an unborn baby is not established. Inform your doctor if pregnant or planning pregnancy. Breastfeeding is not recommended while using this medication.
  • Ziac is not approved for individuals below 18 years old.

How should I take Ziac?

  • Adhere to your doctor’s prescription and carefully follow instructions on the prescription label or provided guides.
  • Report instances of vomiting, diarrhea, or excessive sweating to your doctor promptly, as Ziac can contribute to dehydration, potentially causing low blood pressure, electrolyte imbalances, or kidney failure.
  • Regular blood pressure checks and occasional blood and urine tests may be necessary, particularly during dehydration episodes.
  • Diabetics should monitor blood sugar levels closely, with potential adjustments to insulin or diabetes medication, under a doctor’s guidance.
  • If surgery or medical tests are planned, notify the healthcare provider about current Ziac usage. Temporary discontinuation may be required.
  • Do not abruptly cease Ziac usage; gradual tapering over approximately two weeks is recommended to avoid withdrawal symptoms.

Dosing Information

  • Usual Adult Dose of Ziac for Hypertension:
  • Initial dose: Bisoprolol 2.5 mg-Hydrochlorothiazide 6.25 mg orally once a day
  • Maximum dose: Bisoprolol 20 mg-Hydrochlorothiazide 12.5 mg orally once a day
  • Increase the dose every 14 days if optimal response is not achieved.
  • Substitution for titrated individual components or abrupt discontinuation should be avoided.

Missed Dose and Overdose

  • Take the missed dose promptly if possible, but skip it if close to the next scheduled dose. Avoid double doses.
  • In case of an overdose, seek emergency medical attention or contact the Poison Help line at 1-800-222-1222. Symptoms may include confusion, leg cramps, numbness and tingling, slow heartbeats, or fainting.

What should I avoid while taking Ziac?

  • Avoid alcohol consumption, as it may elevate bisoprolol blood levels.
  • Rise slowly from sitting or lying positions to prevent dizziness.

Ziac Side Effects

  • Seek emergency medical attention for allergic reactions or severe skin reactions.
  • Contact your doctor if experiencing chest pain, irregular heartbeats, light-headedness, blurred vision, shortness of breath, liver problems, signs of electrolyte imbalance, or low blood sugar symptoms.
  • Common side effects include dizziness, weakness, diarrhea, nausea, headache, or cough.

What other drugs will affect Ziac?

  • Inform your doctor about all medications, including colestipol, cholestyramine, insulin, diabetes medicine, lithium, sedatives, narcotic medicine, heart or blood pressure medicine, NSAIDs, and steroids.
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