Bisoprolol/Hydrochlorothiazide

DEA Class;  Rx

Common Brand Names; Ziac

Although the probability of developing hypokalemia is reduced with therapy because of very low dose of HCTZ employed, periodic determination of serum electrolytes should be performed, and patients should be observed for signs of fluid or electrolyte disturbances, eg, hyponatremia, hypochloremic alkalosis, hypokalemia, and hypomagnesemia

Thiazides have been shown to increase urinary excretion of magnesium; this may result in hypomagnesemia; warning signs or symptoms of fluid and electrolyte imbalance include dryness of mouth, thirst, weakness, lethargy, drowsiness, restlessness, muscle pains or cramps, muscular fatigue, hypotension, oliguria, tachycardia, and gastrointestinal disturbances such as nausea and vomiting

Hypokalemia may develop, especially with brisk diuresis when severe cirrhosis is present, during concomitant use of corticosteroids or adrenocorticotropic hormone (ACTH) or after prolonged therapy; interference with adequate oral electrolyte intake will also contribute to hypokalemia; hypokalemia and hypomagnesemia can provoke ventricular arrhythmias or sensitize or exaggerate the response of the heart to the toxic effects of digitalis; hypokalemia may be avoided or treated by potassium supplementation or increased intake of potassium-rich foods

Dilutional hyponatremia may occur in edematous patients in hot weather; appropriate therapy is water restriction rather than salt administration, except in rare instances when hyponatremia is life-threatening; in actual salt depletion, appropriate replacement is therapy of choice

Calcium excretion is decreased by thiazides, and pathologic changes in parathyroid glands, with hypercalcemia and hypophosphatemia, have been observed in a few patients on prolonged thiazide therapy

There are no adequate and well-controlled studies on pregnant women; therapy should be used during pregnancy only if potential benefit justifies risk to fetus

Bisoprolol fumarate alone or in combination with HCTZ has not been studied in nursing mothers; thiazides are excreted in human breast milk; small amounts of bisoprolol fumarate(<2% of the dose) have been detected in milk of lactating rats; because of potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or discontinue drug, taking into account importance of drug to mother

Bisoprolol fumarate/Hydrochlorothiazide

tablet

• 2.5mg/6.25mg
• 5mg/6.25mg
• 10mg/6.25mg