Ziac

Generic name: Bisoprolol fumarate and hydrochlorothiazide

What is Ziac?

Ziac is a blood pressure lowering product that contains two different medicines: bisoprolol fumarate and hydrochlorothiazide. Bisoprolol fumarate is a beta-1 selective adrenergic blocker, which means that it blocks a certain type of receptor found in the heart muscle. Hydrochlorothiazide is a medication that helps your body make urine, to get rid of excess fluid and lower your blood pressure. These two medications work together to lower blood pressure in patients who did not have enough blood pressure lowering from other medications.

What is the most important information I should know about Ziac?

You should take Ziac continuously—do not abruptly stop without first consulting your doctor. Suddenly stopping therapy may lead to withdrawal symptoms such as the worsening of chest pain, fast or irregular heartbeat, or even a heart attack. 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, especially if you have certain kinds of heart disease. If chest pain becomes more severe or a heart problem develops, Ziac should be restarted at once, at least temporarily, and other measures to help unstable chest pain should be taken. 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 mask the signs and symptoms of low blood sugar, especially in diabetics. If you have diabetes, monitor your blood sugar frequently, especially when you first start taking Ziac. Signs of low blood sugar may include a rapid heartbeat, anxiety, sweating, weakness, dizziness, drowsiness, faintness, vision changes, headache, chills, tremors, or an increase in appetite. Ask your doctor before you change the dose of your diabetes medicine.

Ziac may also mask the signs of an underlying thyroid disorder such as rapid heart rate.

This medication may cause alterations in the levels of electrolytes (important elements and minerals) in your blood. It is important to stay hydrated while taking Ziac.

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

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.

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 may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Ziac. Use 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.

Who should not take Ziac?

You should not take Ziac if you have been diagnosed with heart conditions called sinus bradycardia (a type of slow heartbeat), heart block greater than first degree, severe heart failure, inability to produce urine, allergy to sulfonamide-derived medicines, or a life-threatening condition known as cardiogenic shock. You should not take Ziac if you are allergic or sensitive to Ziac or any of its ingredients.

What should I tell my doctor before I take the first dose of Ziac?

Mention all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Ziac. Also, talk to your doctor about your complete medical history, especially if you have diabetes, asthma, COPD or any other disease that can make it hard for you to breathe, gout, overactive thyroid, blood vessel problems, lupus, pheochromocytoma (a type of tumor found in the adrenal glands), or any type of liver, kidney, or heart problems. Tell your doctor if you have a history of anaphylactic reactions to allergens, because Ziac may decrease the effectiveness of epinephrine.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: The usual starting dose is 2.5/6.25 milligrams (mg) taken once a day (equivalent to 2.5 mg of bisoprolol fumarate and 6.25 mg of hydrochlorothiazide). Your doctor may then increase your dose (usually every 14 days) up to 20/12.5 mg per day (given once daily or in 2 divided doses) depending on your condition.

If withdrawal of Ziac therapy is planned, it should be achieved gradually over a period of about 2 weeks. Patients should be carefully observed.

How should I take Ziac?

Ziac should be taken at the same time every day and can be taken with or without food.

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.

You should take Ziac continuously—do not abruptly stop without first consulting your doctor. Suddenly stopping therapy may lead to the worsening of chest pain or even cause a heart attack.

What should I avoid while taking Ziac?

You should avoid operating an automobile or heavy machinery, as well as engaging in other tasks that require mental alertness, until you know how Ziac will affect you. You should also avoid becoming dehydrated while taking Ziac, as this may cause your blood pressure to drop too low.

You should take Ziac continuously—do not abruptly stop without first consulting your doctor.

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

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.

Do not stand or sit up quickly when taking Ziac, especially in the morning. Sit or lie down at the first sign of dizziness, light-headedness, or fainting.

What are possible food and drug interactions associated with Ziac?

If Ziac is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Ziac with the following: alcohol, allopurinol, amantadine, barbiturates, beta-blockers or blood pressure lowering medicines, cimetidine, cholestyramine, clonidine, colestipol, corticosteroids or ACTH, diazoxide, digitalis, diltiazem, disopyramide, guanethidine, insulin or oral antidiabetic medicines, lithium, narcotics, nonsteroidal anti-inflammatory medications (such as ibuprofen or naproxen), norepinephrine, reserpine, and verapamil.

What are the possible side effects of Ziac?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: diarrhea, fatigue, dizziness, light-headedness, headache

Ziac may mask the signs and symptoms of low blood sugar, especially in diabetics. Signs of low blood sugar may include a rapid heartbeat, anxiety, sweating, weakness, dizziness, drowsiness, faintness, vision changes, headache, chills, tremors, or an increase in appetite. Contact your doctor if any of these symptoms occur.

Suddenly stopping therapy with Ziac may lead to withdrawal symptoms such as the worsening of chest pain, fast or irregular heartbeat, or even a heart attack. Contact your doctor immediately if any of these symptoms occur.

Can I receive Ziac if I am pregnant or breastfeeding?

The effects of Ziac during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Ziac?

If you forget to take Ziac, take it as soon as you remember. If it is closer to your next scheduled dose, skip the dose you missed and take Ziac according to your regular dosing schedule. Do not double your doses.

How should I store Ziac?

Store at room temperature away from heat, moisture, and light. Do not store in the bathroom.