Bisoprolol Fumarate (bis-oh-PROE-lol FUE-ma-rate), Hydrochlorothiazide (hye-droe-klor-oh-THYE-a-zide)

Treats high blood pressure. This medicine is a combination of a beta blocker and a diuretic (water pill).

Brand Name(s):

Ziac

When This Medicine Should Not Be Used:

How to Use This Medicine:

Tablet

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Swallow the tablet whole. Do not crush, break, or chew it.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how benazepril/hydrochlorothiazide works. Tell your doctor if you are using any of the following:
  • Cholestyramine, clonidine, colestipol, digoxin, diltiazem, disopyramide, lithium, rifampin, verapamil
  • Insulin or oral diabetes medicine
  • NSAIDs (including aspirin, celecoxib, diclofenac, ibuprofen, naproxen)
  • Other blood pressure medicines
  • Steroid medicine
• Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.
• Alcohol, narcotic pain medicine, or sleeping pills may cause you to feel more lightheaded, dizzy, or faint when used with this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart or blood vessel disease, chest pain (angina), diabetes, gout, lung problems, lupus, an overactive thyroid, or a history of asthma. Tell your doctor if you are fasting (including surgery, not eating regularly, vomiting).
• This medicine may cause the following problems:
  • New or worsening heart failure
  • Eye or vision problems, including glaucoma, myopia
  • Low blood sugar
  • Parathyroid gland problems
  • High uric acid in the blood
  • Increased risk of skin cancer
  • Increased risk for hypoglycemia (low blood sugar) and cover up the symptoms of low blood sugar (including fast heartbeat)
• Do not stop using this medicine suddenly without asking your doctor, or you could develop life-threatening heart problems.
• Tell any doctor or dentist who treats you that you are using this medicine, especially before you have any type of surgery.
• This medicine may cause you to feel dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you are dizzy or lightheaded.
• This medicine may make your skin more sensitive to sunlight. Wear sunscreen. Do not use sunlamps or tanning beds.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Blurred vision or changes in vision
• Change in how much or how often you urinate
• Confusion, weakness, and muscle twitching
• Dry mouth, increased thirst, or muscle cramps
• Fast, slow, pounding, or uneven heartbeat
• Lightheadedness, dizziness, or fainting
• Shaking, trembling, sweating, hunger
• Sores, reddish patch or irritated area, shiny bump, pink growth, or white, yellow or waxy scar-like area on the skin
• Swelling in your hands, feet, ankles, or legs, tiredness

If you notice these less serious side effects, talk with your doctor:

• Constipation, diarrhea, loss of appetite, or stomach upset
• Joint or muscle pain

If you notice other side effects that you think are caused by this medicine, tell your doctor

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