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Drugs reference index «bisoprolol and hydrochlorothiazide»

bisoprolol and hydrochlorothiazide (Oral route)

bis-oh-PROE-lol FUE-ma-rate, hye-droe-klor-oh-THYE-a-zide

Commonly used brand name(s):

In the U.S.

  • Ziac

Available Dosage Forms:

  • Tablet

Therapeutic Class: Beta-Adrenergic Blocker, Cardioselective/Thiazide Combination

Pharmacologic Class: Bisoprolol

Chemical Class: Thiazide

Uses For bisoprolol and hydrochlorothiazide

Bisoprolol and hydrochlorothiazide combination is used to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled .

Bisoprolol is a beta-blocker. It works by affecting the response to some nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart .

Hydrochlorothiazide is a diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine, which helps to lower blood pressure .

bisoprolol and hydrochlorothiazide is available only with your doctor's prescription .

Before Using bisoprolol and hydrochlorothiazide

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For bisoprolol and hydrochlorothiazide, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to bisoprolol and hydrochlorothiazide or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of bisoprolol and hydrochlorothiazide combination in the pediatric population. Safety and efficacy have not been established .

Geriatric

Appropriate studies performed to date have not demonstrated geriatrics-specific problems that would limit the usefulness of bisoprolol and hydrochlorothiazide combination in the elderly. However, elderly patients are more likely to have age-related liver or kidney problems, which may require an adjustment of dosage in patients receiving bisoprolol and hydrochlorothiazide combination .

Pregnancy

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Bisoprolol

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Hydrochlorothiazide

Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.

Interactions with Medicines

Using bisoprolol and hydrochlorothiazide with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Dofetilide

Using bisoprolol and hydrochlorothiazide with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acetyldigoxin
  • Albuterol
  • Amiodarone
  • Arformoterol
  • Arsenic Trioxide
  • Bambuterol
  • Bitolterol
  • Broxaterol
  • Clenbuterol
  • Clonidine
  • Colterol
  • Deslanoside
  • Digitalis
  • Digitoxin
  • Digoxin
  • Diltiazem
  • Dronedarone
  • Droperidol
  • Fenoldopam
  • Fenoterol
  • Fentanyl
  • Flecainide
  • Formoterol
  • Hexoprenaline
  • Isoetharine
  • Ketanserin
  • Levalbuterol
  • Levomethadyl
  • Lithium
  • Metaproterenol
  • Metildigoxin
  • Ouabain
  • Pirbuterol
  • Procaterol
  • Proscillaridin
  • Reproterol
  • Rimiterol
  • Ritodrine
  • Salmeterol
  • Sotalol
  • Terbutaline
  • Tretoquinol
  • Tulobuterol
  • Verapamil

Using bisoprolol and hydrochlorothiazide with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acarbose
  • Aceclofenac
  • Acemetacin
  • Acetohexamide
  • Alacepril
  • Alclofenac
  • Alfuzosin
  • Amlodipine
  • Apazone
  • Arbutamine
  • Benazepril
  • Benfluorex
  • Benoxaprofen
  • Bepridil
  • Bromfenac
  • Bufexamac
  • Bunazosin
  • Calcium Carbonate
  • Captopril
  • Carbamazepine
  • Carprofen
  • Celecoxib
  • Chlorpropamide
  • Cholestyramine
  • Cilazapril
  • Clometacin
  • Clonixin
  • Cyclophosphamide
  • Delapril
  • Dexketoprofen
  • Diclofenac
  • Diflunisal
  • Digoxin
  • Dipyrone
  • Doxazosin
  • Droxicam
  • Enalaprilat
  • Enalapril Maleate
  • Etodolac
  • Etofenamate
  • Felbinac
  • Felodipine
  • Fenbufen
  • Fenoprofen
  • Fentiazac
  • Floctafenine
  • Flufenamic Acid
  • Flurbiprofen
  • Fosinopril
  • Ginkgo
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Gossypol
  • Guar Gum
  • Ibuprofen
  • Imidapril
  • Indomethacin
  • Indoprofen
  • Insulin
  • Insulin Aspart, Recombinant
  • Insulin Glulisine
  • Insulin Lispro, Recombinant
  • Isoxicam
  • Ketoprofen
  • Ketorolac
  • Lacidipine
  • Lercanidipine
  • Licorice
  • Lisinopril
  • Lornoxicam
  • Manidipine
  • Meclofenamate
  • Mefenamic Acid
  • Meloxicam
  • Metformin
  • Methyldopa
  • Mibefradil
  • Miglitol
  • Moexipril
  • Moxisylyte
  • Nabumetone
  • Naproxen
  • Nicardipine
  • Nifedipine
  • Niflumic Acid
  • Nilvadipine
  • Nimesulide
  • Nimodipine
  • Nisoldipine
  • Nitrendipine
  • Oxaprozin
  • Oxyphenbutazone
  • Pentopril
  • Perindopril
  • Phenoxybenzamine
  • Phentolamine
  • Phenylbutazone
  • Pirazolac
  • Piroxicam
  • Pirprofen
  • Pranidipine
  • Prazosin
  • Propyphenazone
  • Proquazone
  • Quinapril
  • Ramipril
  • Repaglinide
  • Rifapentine
  • Rofecoxib
  • Spirapril
  • St John's Wort
  • Sulindac
  • Suprofen
  • Tamsulosin
  • Temocapril
  • Tenidap
  • Tenoxicam
  • Terazosin
  • Tiaprofenic Acid
  • Ticrynafen
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Topiramate
  • Trandolapril
  • Trimazosin
  • Troglitazone
  • Urapidil
  • Zofenopril
  • Zomepirac

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of bisoprolol and hydrochlorothiazide. Make sure you tell your doctor if you have any other medical problems, especially:

  • Angina (severe chest pain)—May provoke chest pain if stopped too quickly .
  • Anuria (not able to form urine) or
  • Bradycardia (slow heartbeat) or
  • Heart block or
  • Heart failure—Should not use in patients with these conditions .
  • Blood vessel disease (circulation problems) or
  • Gout or
  • Hyperuricemia (high uric acid in the blood) or
  • Hypochloremia (low chloride in the blood) or
  • Hypokalemia (low potassium in the blood) or
  • Hypomagnesemia (low magnesium in the blood) or
  • Hyponatremia (low sodium in the blood) or
  • Parathyroid disease or
  • Systemic lupus erythematosus—Use with caution. bisoprolol and hydrochlorothiazide may make these conditions worse .
  • Diabetes or
  • Hyperthyroidism (overactive thyroid) or
  • Hypoglycemia (low blood sugar)—May cover up some of the signs and symptoms of these diseases, such as a fast heartbeat .
  • Kidney disease or
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body .
  • Lung disease (e.g., asthma, bronchitis, emphysema)—May cause difficulty with breathing in patients with this condition .
  • Sympathectomy—Use with caution. The effects of bisoprolol and hydrochlorothiazide may be increased .

Proper Use of bisoprolol and hydrochlorothiazide

In addition to the use of bisoprolol and hydrochlorothiazide, treatment for your high blood pressure may include weight control and changes in the types of foods you eat, especially foods high in sodium. Your doctor will tell you which of these are most important for you. You should check with your doctor before changing your diet .

Many patients who have high blood pressure will not notice any signs of the problem. In fact, many may feel normal. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well .

Remember that bisoprolol and hydrochlorothiazide will not cure your high blood pressure, but it does help control it. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. You may have to take high blood pressure medicine for the rest of your life. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease .

Do not interrupt or stop taking bisoprolol and hydrochlorothiazide without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are taking before stopping it completely. Some conditions may become worse when the medicine is stopped suddenly, which can be dangerous .

Dosing

The dose of bisoprolol and hydrochlorothiazide will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of bisoprolol and hydrochlorothiazide. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For high blood pressure:
      • Adults—One tablet once a day.
      • Children—Use and dose must be determined by your doctor .

Missed Dose

If you miss a dose of bisoprolol and hydrochlorothiazide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using bisoprolol and hydrochlorothiazide

It is very important that your doctor check your progress at regular visits to make sure bisoprolol and hydrochlorothiazide is working properly and to check for unwanted effects .

bisoprolol and hydrochlorothiazide may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort; dilated neck veins; extreme fatigue; irregular breathing; an irregular heartbeat; shortness of breath; swelling of the face, fingers, feet, or lower legs; weight gain; or wheezing .

bisoprolol and hydrochlorothiazide may cause changes in your blood sugar levels. Also, bisoprolol and hydrochlorothiazide may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests .

Make sure any doctor or dentist who treats you knows that you are using bisoprolol and hydrochlorothiazide. You may need to stop using bisoprolol and hydrochlorothiazide several days before having surgery or medical tests .

bisoprolol and hydrochlorothiazide may cause some people to become less alert than they are normally. If this side effect occurs, do not drive, use machines, or do anything else that could be dangerous if you are not alert while taking bisoprolol and hydrochlorothiazide .

bisoprolol and hydrochlorothiazide may cause your skin to be more sensitive to sunlight than normal. Be sure to apply sunscreen before going outside, and wear protective clothing and a hat .

bisoprolol and hydrochlorothiazide Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
  • Bloating or swelling of face, arms, hands, lower legs, or feet
  • chest pain or discomfort
  • lightheadedness, dizziness, or fainting
  • rapid weight gain
  • shortness of breath
  • slow or irregular heartbeat
  • tingling of hands or feet
  • unusual tiredness or weakness
  • unusual weight gain or loss

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
  • Anxiety
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in consciousness
  • chills
  • cold clammy skin
  • cold sweats
  • confusion as to time, place, or person
  • cool, pale skin
  • cough
  • decrease in amount of urine
  • depression
  • difficulty breathing
  • dilated neck veins
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • drowsiness
  • dry mouth
  • extreme fatigue
  • fast or pounding heartbeat or pulse
  • fast, weak pulse
  • frequent urination
  • hallucinations
  • holding false beliefs that cannot be changed by fact
  • increased hunger
  • increased thirst
  • increased volume of pale, dilute urine
  • irregular breathing
  • irritability
  • loss of appetite
  • loss of consciousness
  • mood changes
  • muscle pain or cramps
  • nausea or vomiting
  • nervousness
  • nightmares
  • no breathing
  • noisy breathing
  • not able to pass urine
  • numbness or tingling in hands, feet, or lips
  • pain or aching in lower legs
  • seizures
  • shakiness
  • slurred speech
  • sweating
  • swelling of face, hands, fingers, feet, ankles, or lower legs
  • tightness in chest
  • trembling
  • troubled breathing
  • unconsciousness
  • unusual drowsiness, dullness, or feeling of sluggishness
  • unusual excitement, nervousness, or restlessness
  • very drowsy or sleepy
  • weakness and heaviness of legs
  • weight gain
  • wheezing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Acid or sour stomach
  • belching
  • decreased interest in sexual intercourse
  • diarrhea
  • difficulty in moving
  • heartburn
  • inability to have or keep an erection
  • indigestion
  • joint pain
  • loss in sexual ability, desire, drive, or performance
  • muscle aching or stiffness
  • sleepiness
  • stomach discomfort, upset, or pain
  • swollen joints
Rare
  • Runny nose
  • sneezing
  • stuffy nose

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

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