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All about: hydrochlorothiazide and bisoprolol

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Generic Name: hydrochlorothiazide and bisoprolol (hye droe klor oh THYE a zide and bis OH proe lole)
Brand Names: Ziac

What is hydrochlorothiazide and bisoprolol?

Bisoprolol is in a class of drugs called beta-blockers. Bisoprolol is used to lower blood pressure, lower heart rate, reduce angina (chest pain), and reduce the risk of recurrent heart attacks.

Hydrochlorothiazide is a thiazide diuretic (water pill). It helps to lower your blood pressure and decrease edema (swelling) by increasing the amount of salt and water you lose in your urine.

Hydrochlorothiazide and bisoprolol is used to treat high blood pressure (hypertension).

Hydrochlorothiazide and bisoprolol may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about hydrochlorothiazide and bisoprolol?

To reduce nighttime urination, take hydrochlorothiazide and bisoprolol before 6 p.m. and preferably in the morning.

Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse.

Who should not take hydrochlorothiazide and bisoprolol?

Do not take hydrochlorothiazide and bisoprolol if you have an allergy to sulfa-based drugs such as sulfa antibiotics. You may have an allergic reaction to hydrochlorothiazide.

Before taking this medication, tell your doctor if you have

  • asthma;

  • a heart condition such as low blood pressure, heart block, a pacemaker, or heart failure, or any other heart problem;

  • diabetes;

  • gout;

  • a collagen vascular disease such as systemic lupus erythematosus;

  • pancreatitis;

  • kidney disease;
  • liver disease;
  • any type of circulatory disease; or

  • thyroid disease.

You may not be able to take hydrochlorothiazide and bisoprolol, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.

Hydrochlorothiazide and bisoprolol is in the FDA pregnancy category C. This means that it is not known whether hydrochlorothiazide and bisoprolol will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. Hydrochlorothiazide and bisoprolol passes into breast milk and may harm a nursing infant. Do not take this medication without first talking to your doctor if you are breast-feeding a baby.

How should I take hydrochlorothiazide and bisoprolol?

Take hydrochlorothiazide and bisoprolol exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each dose with a full glass of water.

To reduce nighttime urination, take hydrochlorothiazide and bisoprolol before 6 p.m. and preferably in the morning.

Do not stop taking this medication unless your doctor approves. If you stop taking your medication, your condition could become much worse. Store hydrochlorothiazide and bisoprolol at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of an bisoprolol and hydrochlorothiazide overdose include an irregular heartbeat, seizures, confusion, fainting, coma, shortness of breath, and wheezing.

What should I avoid while taking hydrochlorothiazide and bisoprolol?

Avoid a diet high in salt. Too much salt will cause your body to retain water and will decrease the effects of hydrochlorothiazide.

Avoid prolonged exposure to sunlight. Hydrochlorothiazide and bisoprolol may increase the sensitivity of your skin to sunlight. Use a sunscreen and wear protective clothing when exposure to the sun is unavoidable.

Avoid becoming overheated in hot weather. It is easy to become dangerously dehydrated while taking hydrochlorothiazide.

Use caution when driving, operating machinery, or performing other hazardous activities. Hydrochlorothiazide and bisoprolol may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Also use caution when rising from a sitting or lying position. Use alcohol cautiously. Alcohol may further lower blood pressure and increase drowsiness and dizziness while you are taking hydrochlorothiazide and bisoprolol.

Before having surgery, tell your doctor or dentist that you are taking this medication.

Hydrochlorothiazide and bisoprolol side effects

If you experience any of the following serious side effects, stop taking hydrochlorothiazide and bisoprolol and seek emergency medical attention:
  • an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);

  • yellow skin or eyes;

  • confusion;

  • abnormal bleeding or bruising;

  • unusual fatigue;

  • a slow or irregular heartbeat, chest pain;

  • swelling of your feet and lower legs, or sudden weight gain;

  • cold or blue feet and hands; or

  • a rash.

Other, less serious side effects may be more likely to occur. Continue to take hydrochlorothiazide and bisoprolol and talk to your doctor if you experience

  • dizziness;

  • unusual headache or fatigue;

  • tingling or numbness in your arms, legs, hands, or feet;

  • excessive urination or increased hunger or thirst;

  • nausea or decreased appetite;

  • diarrhea, constipation, gas, nausea, or vomiting;

  • weak pulse;

  • muscle weakness or cramps;

  • depression or nightmares; or

  • sensitivity to sunlight.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect hydrochlorothiazide and bisoprolol?

The following medicines may decrease the effectiveness of hydrochlorothiazide and bisoprolol:

  • cholestyramine (Questran) and colestipol (Colestid);

  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil), ketoprofen (Orudis, Orudis KT, Oruvail), and naproxen (Naprosyn, Anaprox, Aleve); and
  • other commonly used NSAIDs, including diclofenac (Cataflam, Voltaren), etodolac (Lodine), fenoprofen (Nalfon), flurbiprofen (Ansaid), indomethacin (Indocin), ketorolac (Toradol), mefenamic acid (Ponstel), nabumetone (Relafen), oxaprozin (Daypro), piroxicam (Feldene), sulindac (Clinoril), and tolmetin (Tolectin).

Larger doses of hydrochlorothiazide and bisoprolol may be needed if you are taking any of the medicines listed above.

Before taking bisoprolol and hydrochlorothiazide, tell your doctor if you are taking any of the medicines listed below:

  • Oral diabetes medications such as glipizide (Glucotrol), glyburide (Micronase, Glynase, Diabeta), chlorpropamide (Diabinese), tolazamide (Tolinase), and tolbutamide (Orinase) may not be as effective in lowering your blood sugar when you are taking hydrochlorothiazide and bisoprolol. Your diabetes therapy may have to be adjusted.

  • Lithium (Lithobid, Eskalith, others) generally should not be taken with hydrochlorothiazide and bisoprolol because dangerous side effects may result.

  • Other drugs that lower blood pressure must be used very cautiously. Very low blood pressure can result. Some drugs commonly used to lower blood pressure include acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), carteolol (Cartrol), labetalol (Trandate, Normodyne), propranolol (Inderal), pindolol (Visken), timolol (Blocadren), benazepril (Lotensin), enalapril (Vasotec), captopril (Capoten), fosinopril (Monopril), moexipril (Univasc), quinapril (Accupril), ramipril (Altace), amlodipine (Norvasc), bepridil (Vascor), diltiazem (Cardizem, Dilacor), felodipine (Plendil), isradipine (Dynacirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), and verapamil (Calan, Verelan, Isoptin).

Drugs other than those listed here may also interact with hydrochlorothiazide and bisoprolol or affect your condition. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

Where can I get more information?

  • Your pharmacist has additional information about hydrochlorothiazide and bisoprolol written for health professionals that you may read.

What does my medication look like?

Hydrochlorothiazide and bisoprolol is available with a prescription under the brand name Ziac. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

Bisoprolol/hydrochlorothiazide strengths are as follows:

  • Ziac 2.5 mg/6.25 mg--yellow, round, convex, film-coated tablets

  • Ziac 5 mg/6.25 mg--pink, round, convex, film-coated tablets

  • Ziac 10 mg/6.25 mg--white, round, convex, film-coated tablets

  • 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.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 4.03. Revision Date: 2/13/04 4:05:06 PM.

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