Ziac (Bisoprolol/Hctz)

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Ziac Brand
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Bisoprolol/Hctz (Generic alternate to Ziac) Generic

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Table of contents:

Ziac is a medication that is used to treat high blood pressure (hypertension). It contains two active ingredients, bisoprolol and hydrochlorothiazide. Bisoprolol is a beta-blocker that works by blocking the effects of certain natural chemicals in the body, such as adrenaline. This helps to reduce the heart rate and blood pressure. Hydrochlorothiazide is a diuretic (water pill) that helps to remove excess salt and water from the body, which also helps to lower blood pressure.

Ziac causes your body to get rid of extra salt and water, which probably helps to relax the blood vessels so that blood can flow more easily. These two drugs are used together when one medication is not controlling your blood pressure. Using these two drugs together can also reduce the amount of each drug you must take, thereby decreasing the chances of side effects.

Uses and Dosage

Ziac is a tablet medication that is typically taken once daily by mouth with or without food, based on your medical condition and how you respond to treatment. Avoid taking Ziac within 4 hours of going to bed so as not to interrupt your sleep with urination. If you have any questions about your dosing schedule, consult your doctor or pharmacist. When taking cholestyramine or colestipol, make sure to take bisoprolol/hydrochlorothiazide at least 4 hours before or after taking these drugs.

The recommended dosage for Ziac depends on each individual's medical condition and response to treatment. Antihypertensive therapy may be initiated with the lowest dose of Ziac, which is one 2.5/6.25 mg tablet taken orally once daily. Subsequent titration at 14-day intervals may be necessary depending on the individual's blood pressure response. The maximum recommended daily dosage is two 10mg/6.25mg tablets (20mg bisoprolol + 12.5mg HCTZ) taken once daily. However, the lowest possible dose should be used based on each patient's medical condition.

To derive the most benefit from Ziac, use it regularly and try to always take it at the same time each day. Do not discontinue taking Ziac even if you feel well. Most people with high blood pressure do not experience any symptoms. It might take up to 3 weeks before you feel any significant effect of the medication.

Side Effects

Common Side Effects of Ziac (Bisoprolol/Hctz):

  • Cough
  • Diarrhea
  • Dizziness
  • Feeling weak or tired
  • Headache
  • Nausea
  • Runny nose
  • Sleep problems (insomnia)
  • Spinning sensation
  • Upset stomach

Serious Side Effects of Ziac (Bisoprolol/Hctz):

  • Blurred vision
  • Burning in your eyes
  • Chest pain
  • Clay-colored stools
  • Confusion
  • Constipation
  • Dark urine
  • Difficulty breathing
  • Dizziness
  • Extreme thirst
  • Eye pain
  • Fast, slow, or uneven heartbeats
  • Feeling jittery
  • Fluttering in your chest
  • Headache
  • Hives
  • Hungers
  • Increased urination
  • Irregular heartbeats
  • Irritability
  • Itching
  • Leg cramps
  • Lightheadedness
  • Limp feeling
  • Loss of appetite
  • Muscle weakness
  • Nausea
  • Numbness or tingling
  • Rapid weight gain
  • Red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling
  • Seeing halos around light
  • Shortness of breath
  • Skin pain
  • Sore throat
  • Sweating
  • Swelling of your face lips tongue or throat
  • Tiredness
  • Tunnel vision
  • Upper stomach pain
  • Weakness
  • Yellowing of the skin or eyes (jaundice)

Form and Strength

Ziac (Bisoprolol/Hctz) is available in the following forms and strength:

Ziac: Tablet

  • 5/6.25mg


  • Patients with a history of hypersensitivity to either bisoprolol or hydrochlorothiazide should not take this medication.
  • Use caution in patients with liver disease, as bisoprolol is metabolized in the liver and its elimination may be prolonged in patients with hepatic impairment.
  • Use caution in patients with renal impairment, as hydrochlorothiazide may cause electrolyte imbalances and exacerbate renal impairment.
  • This drug may cause dizziness or lightheadedness, especially at the start of treatment or when the dosage is increased. Patients should avoid driving or operating heavy machinery until they know how the drug affects them.
  • Use caution in patients with a history of asthma or other lung diseases, as beta-blockers like bisoprolol may cause bronchospasm and exacerbate breathing difficulties.
  • Use caution in diabetics, as this medication may mask some of the symptoms of hypoglycemia (low blood sugar) such as tachycardia, palpitations, sweating or tremors.
  • Hydrochlorothiazide may increase levels of uric acid and cause gout attacks in susceptible patients.
  • Use caution in patients with heart failure, as beta-blockers may worsen symptoms of heart failure.
  • Hydrochlorothiazide can cause electrolyte disturbances, such as hypokalemia, hyponatremia, and hypomagnesemia, which can lead to cardiac arrhythmias or muscle weakness.
  • Use caution in patients with kidney impairment or a history of kidney stones, as hydrochlorothiazide may increase the risk of kidney damage or stones.
  • Bisoprolol may cause a decrease in heart rate and blood pressure in some patients, which may require dose adjustments or discontinuation of the drug.
  • Use caution in patients taking insulin or oral hypoglycemic agents, as this medication may mask some of the symptoms of hypoglycemia and reduce the effectiveness of these agents.

Frequently Asked Questions (FAQ)

Can Ziac cause weight gain?

Beta blockers, like bisoprolol, can cause weight gain as a side effect, although it is not a common side effect of the drug. If you experience significant weight gain while taking Ziac, you should discuss it with your healthcare provider.

Can Ziac be taken with food?

Ziac can be taken with or without food, based on the preference of the patient. However, taking the medication with a meal may help reduce the risk of stomach upset.

How long does it take for Ziac to start working?

The onset of action of Ziac may vary depending on the individual and the specific dosage regimen. However, it may take several weeks of continuous use to achieve a maximal blood pressure-lowering effect.

Can Ziac be taken in the evening?

Ziac can be taken at any time of day, provided it is taken at the same time each day. However, some patients may experience trouble sleeping if they take the medication in the evening, so it is often recommended to take it in the morning.

Can Ziac be stopped abruptly?

Abruptly stopping Ziac can result in a sudden increase in blood pressure, which may lead to serious complications. Patients should never stop taking Ziac without consulting their healthcare provider, and the medication should be gradually tapered off under their supervision.


It's important to purchase Ziac from verified Canadian pharmacy.

Additional information

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Online Pharmacies Canada has provided information from third parties intended to increase awareness and does not contain all the information about Ziac (Bisoprolol/Hctz). Talk to your doctor or other qualified medical practitioners for medical attention or advice, or if you have any concerns about Ziac (Bisoprolol/Hctz).