ZIAC Dosage & Rx Info | Uses, Side Effects

Ziac Generic Name & Formulations

Legal Class

General Description

Bisoprolol (as fumarate), hydrochlorothiazide; 2.5mg/6.25mg, 5mg/6.25mg, 10mg/6.25mg; tabs.

Pharmacological Class

Cardioselective beta-blocker + diuretic.

How Supplied

Tabs 2.5mg/6.25mg, 5mg/6.25mg—100; 10mg/6.25mg—30

Manufacturer

Teva Pharmaceuticals

Generic Availability

YES

Mechanism of Action

Bisoprolol fumarate is a beta1-selective (cardioselective) adrenoceptor blocking agent without significant membrane stabilizing or intrinsic sympathomimetic activities in its therapeutic dose range. Hydrochlorothiazide (HCTZ) is a benzothiadiazine diuretic. Thiazides affect renal tubular mechanisms of electrolyte reabsorption and increase excretion of sodium and chloride in approximately equivalent amounts. Natriuresis causes a secondary loss of potassium.

Ziac Indications

Indications

Hypertension.

Ziac Dosage and Administration

Adult

Initially one 2.5mg/6.25mg tab once daily. Adjust at 14-day intervals; max two 10mg/6.25mg tabs (20mg bisoprolol + 12.5mg HCTZ) once daily.

Children

Not established.

Ziac Contraindications

Contraindications

Cardiogenic shock. Overt heart failure. 2^nd- or 3^rd-degree AV block. Marked sinus bradycardia. Anuria. Sulfonamide allergy.

Ziac Boxed Warnings

Not Applicable

Ziac Warnings/Precautions

Warnings/Precautions

CHF. Peripheral vascular disease. Bronchospastic disease. Surgery. Thyroid disease. Avoid abrupt cessation. Gout. Arrhythmia. SLE. Postsympathectomy. Excessive fluid loss. Monitor electrolytes, BUN (if high). Discontinue if electrolyte disorders develop rapidly. Acute angle-closure glaucoma (with or without acute myopia and choroidal effusions). Diabetes. May mask signs and increase risk for hypoglycemia. Hepatic or renal impairment. Pregnancy. Nursing mothers: not recommended.

Ziac Pharmacokinetics

Metabolism

Hepatic (bisoprolol).

Elimination

Renal. Half-life: 7–15 hours (bisoprolol); 4–10 hours (HCTZ).

Ziac Interactions

Interactions

May potentiate other antihypertensives, reserpine, guanethidine, other catecholamine-depleting drugs, calcium channel blockers, antiarrhythmics, myocardial depressants, nondepolarizing muscle relaxants. Digitalis, lithium toxicity. Antagonized by rifampin, NSAIDs. Increased rebound hypertension with clonidine withdrawal. Adjust antidiabetic, antigout medications. Hyperglycemia, hyperuricemia more likely with diazoxide. NSAIDs may cause renal failure. ACTH, corticosteroids, amphotericin B increase hypokalemia risk. Orthostatic hypotension with alcohol, CNS depressants. May block epinephrine. May interfere with parathyroid tests.

Ziac Adverse Reactions

Adverse Reactions

Dizziness, fatigue, cough, insomnia, diarrhea, muscle cramps, impotence; HCTZ: increased risk for non-melanoma skin cancer.

Ziac Clinical Trials

See Literature

Ziac Note