Part Two of Ziac Information, Focusing on Side Effects, Discontinuation or Withdrawal Effects, and Additional Information

This second section of our medication database entry focuses on potential side effects, withdrawal or discontinuation effects, and additional information, while part one covers basic drug characteristics, uses and benefits.

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What are the possible side effects of hydrochlorothiazide and bisoprolol?

  • 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.
  • 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.

Limitations and the Source of Our Online Medication Information Database

Although we have made considerable efforts to ensure that the information provided here is accurate, up-to-date, and complete, MedLibrary.org makes no guarantee to that effect. Drug information contained herein may be time sensitive. This medication information does not endorse drugs, diagnose patients or recommend any specific pharmacotherapy. This is an educational resource only -- intended to supplement but not to replace the expertise, skill, knowledge and judgment of medically qualified 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. 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, please check with your doctor, nurse or local pharmacist. MedLibrary.org does not assume any responsibility for any aspect of healthcare administered with the aid of information provided here.

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Version: 4.02. Revision Date: 2/14/03.

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