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Ziac (Hydrochlorothiazide/Bisoprolol)
Chronic Care High Blood Pressure Ziac
Chronic Care High Blood Pressure Ziac

Ziac (bisoprolol/ hydrochlorothiazide) prescription available online

If you are living with high blood pressure, Ziac can help. Get a new prescription or refill of Ziac from a board-certified primary care doctor online.*

FDA-approved to treat high blood pressure Available as a tablet Request Ziac in as little as 15 minutes, with or without insurance*
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*Prescriptions are provided at the doctor’s discretion. Learn more about our controlled substances policy and how you can save up to 80% with our prescription discount card.
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About Ziac (bisoprolol/hydrochlorothiazide)

Ziac is a combination of hydrochlorothiazide and bisoprolol. Hydrochlorothiazide is a diuretic (water pill), which increases urination. Bisoprolol is a beta-blocker, which blocks the effects of epinephrine (adrenaline) on the heart and blood vessels, lowering blood pressure and heart rate.

Ziac is used to treat high blood pressure. Ziac is available only by prescription. It is available in a generic formulation as bisoprolol/hydrochlorothiazide tablets.

Ziac and it's generic alternative are both prescribed as a tablet. It’s always important to follow the specific instructions on your prescription, as they can vary based on the formulation and dosage prescribed.

If you're prescribed Ziac, be sure take your medication every day unless your doctor specifically tells you to stop. If you don’t take it daily, the medication may not fully treat your high blood pressure.

Ziac uses

There is one FDA-approved use for Ziac, for the treatment of hypertension.

High blood pressure

Ziac is FDA-approved to treat high blood pressure. Hydrochlorothiazide helps the body get rid of excess salt and water, which helps relax blood vessels and improve blood flow. Bisoprolol slows your heartbeat, lowers blood pressure, and reduces strain on the heart.

Ziac side effects

The side effects of Ziac are typically mild. Most Ziac side effects are associated with dizziness caused by too low of a blood pressure.

Ziac has some common side effects. They may include:

  • Dizziness and lightheadedness

  • Feeling weak or tired

  • Diarrhea, nausea, or indigestion


Other side effects, which are less common but might be more severe, could include:

  • Allergic reactions

  • Fast, slow, or uneven heartbeat

  • Chest pain

  • Low blood sugar

  • Low sodium (hyponatremia)


You should call your doctor if you notice any adverse effects, or if you develop any other new or concerning symptoms. The use of Ziac is not recommended for children under 18 or for people who are pregnant or are planning to become pregnant.

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How to take Ziac

Your physician will provide you with instructions on how to take your Ziac prescription. Be sure to read your prescription label and follow the instructions. Call your doctor or pharmacist if you have any questions.

Ziac can come in different doses, so be sure to follow the specific instructions on your prescription. The initial Ziac dosage for adults is bisoprolol 2.5 mg / hydrochlorothiazide 6.25 mg orally once a day.

What to avoid while taking Ziac

Ziac has numerous possible drug interactions. Don’t change what you are taking without checking with your doctor or pharmacist. That includes other medications, supplements, and over the counter medications.

Possible drug interactions with Ziac include:

  • Insulin or oral diabetes medication

  • Lithium

  • Sedatives or narcotic medicine

  • Other heart or blood pressure medicine

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Steroid medicine such as prednisone 


Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly to prevent a fall, especially when first starting Ziac or increasing your dose.

Ziac can increase your sensitivity to the sun. Wear protective clothing and sunscreen when outdoors.

Because alcohol can lower blood pressure, drinking alcohol while taking Ziac may lead to an increased risk of adverse reactions. Discuss your alcohol use with your doctor.

Medication alternatives to Ziac

If your board-certified primary care physician prefers to put you on another treatment altogether, they may suggest other beta-blockers or diuretics or another drug class altogether. Here are some common doctor-recommended alternatives based on your condition:

High blood pressure

Inderal (propranolol) Trandate (labetalol) Toprol XL (metoprolol) Bystolic (nebivolol) Ziac (bisoprolol / hydrochlorothiazide) Lopressor (metoprolol tartrate) Altace (ramipril) Lotensin (benazepril) Accupril (quinapril) Lotrel (amlodipine & benazepril) Vasotec (enalapril) Tenormin Amlodipine Coreg (carvedilol)
Zestril
Cozaar (losartan) Diovan (valsartan) Benicar (olmesartan)

Ziac prescription FAQs

How much does Ziac cost?

Depending on your pharmacy, brand name Ziac costs around $240 for thirty 10 mg/6.25 mg tablets without insurance. Fortunately, the generic versions bisoprolol/hydrochlorothiazide offers an affordable alternative, costing around $41 for ninety 10 mg / 6.25 mg tablets. Price varies with insurance coverage. Our prescription discount card helps members save up to 80% on prescriptions.

How can I refill my Ziac prescription?

To refill your Ziac prescription, book a virtual appointment with one of our board-certified primary care doctors. After reviewing your symptoms and medical history, your doctor can send an electronic prescription to your local pharmacy, if appropriate to do so.

Who should not take Ziac?

Avoid taking Ziac if you have certain medical conditions, such as:

  • Poorly controlled congestive heart failure or unstable coronary artery disease

  • Sick sinus syndrome or 2nd to 3rd degree AV block

  • Peripheral vascular disease

  • Allergic reaction to sulfa drugs or beta blockers

  • Kidney or liver disease

  • Thyroid disorder

  • Asthma or other breathing disorder

  • Impaired renal function

Does Ziac lower heart rate?

Yes, Ziac can lower your heart rate. Bisoprolol, one of the active ingredients, is a beta-blocker that blocks the effects of epinephrine, also known as adrenaline, on the heart and blood vessels, which lowers heart rate.

Is Ziac good for blood pressure?

Yes, Ziac is an effective medication to lower blood pressure. It combines two medications, a beta-blocker and a diuretic (water pill), into a single pill for convenience.

Can Ziac raise blood sugar?

Yes, Ziac can raise blood sugar. Talk to your doctor before you begin combination therapy if you have diabetes.

What happens if I miss a dose of Ziac?

If you miss a dose of Ziac, take the missed dose as soon as you remember. Skip the missed dose if it's almost time for your next dose. Avoid taking two doses to make up for a missed dose.

What happens if I take too much Ziac?

If you've taken too much Ziac, seek emergency medical attention or contact your local poison control center.

3 simple steps to request your Ziac prescription today

How It Works Step 1
Step 1

Book a Ziac prescription request appointment.

Book a same day appointment from anywhere.
How It Works Step 2
Step 2

Talk to your board-certified primary care physician regarding a Ziac prescription.

Visit with a doctor on your smartphone or computer.
How It Works Step 3
Step 3

Pick up your Ziac prescription.

We can send prescriptions to any local pharmacy.

How pricing works

To get a new or refill on your Ziac prescription, join our monthly membership and get discounted visits.

30 days of free membership

  • Same-day appointments 7 days a week
  • Unlimited messages with your Care Team
  • Prescription discount card to save up to 80%
  • Exclusive discounts on lab tests
  • Free memberships for your family
  • Cancel anytime

Paying with insurance

Membership

$19.99

First month free

+

Visits

Copay

Visit price with insurance

Often the same as an office visit. Most patients with in-network insurance pay $30 or less!

We accept these insurance plans and many more:


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Paying without insurance

Membership

$19.99

First month free

+

Visits

$129

Visit price without insurance

Initial visits are $129.
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*If we're unable to treat you, we'll provide a full refund. Please note that any medication or lab work costs are not included. Please refer to our refund policy for additional information.

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PlushCare content is reviewed by MDs, PhDs, NPs, nutritionists, and other healthcare professionals. Learn more about our editorial standards and meet the medical team. The PlushCare site or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment.