Indications for ZIAC:



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.


Not established.


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


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. Diabetes. Hepatic or renal impairment. Pregnancy. Nursing mothers: not recommended.

Pharmacologic Class:

Cardioselective beta-blocker + diuretic.


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.

Adverse Reactions:

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

How Supplied:

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

Pricing for ZIAC

5mg/6.25mg tablet (Qty: 90)
Appx. price $34