Doctors' Answers to "Frequently Asked Questions" - Ziac

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Ziac [posted 1/8/99]
Question: Hi my mother has high blood pressure and has been put on different kinds of medicines to control it. At times it is under control, but the side effects are insane. The most bothersome is fatigue. She is now on Hyzaar, and she feels very tried also. Next week the doctor was going to try putting her on Ziac. We were told it's a drug with the least amount of side effects. Is this true or false. Is there a blood pressure medicine out there with every few side effects?

Answer: Well, it has less side effects due to small doses of its beta blocker and diuretic. However, fatigue is the usual one. I would try an ACE inhibitor and push the doses. Also, ensure she is checking her bp at home so that she is not over-treating herself (very common since bp rises generally in a doctor's office).

Breathlessness & Ziac [posted 11/10/98]
Question: I am a 40 year old white male, I've been taking Ziac for about 1 year and it has caused breathlessness for most of the time however I thought it might be daily stress of running my own business.I have sold the business and moved to the virgin islands trying to remove some stress in my life and I have. After 2 months in my new life I'm still short of breath alot and more if I done simple chores. I am not over weight and heart desease is not in family history, I appear in better than average physical shape and do not smoke.I'm currently taking 100Mgs. daily and I do not feel well for about 1-2 hours after taking in morning.

Answer: Ziac is a combination of a beta blocker and a diuretic. Beta blockers are known to produce asthma in some patients and this is a relatively contraindication. If it persists after stopping the Ziac you should have a stress test to rule out an angina equivalent. This should be discussed with your md and you should be on some other antianginal -calcium channel blocker probably when you discontinue the ziac.

Tremors & Ziac [posted 10/15/98]
Question: I am currently taking Ziac 10mg. I am experiencing a tremor-like sensation between my shoulder blades and up my neck. This happens intermittently.Sometimes it ceases for a few days, and then it starts up again. I consulted my Dr. about this and he changed my medication with disasterous results. I am finally back on Ziac, but the trembling still continues. Could this possibly be from the blood pressure medicine? No one can seem to find a reason for this.I'm border line high blood pressure 140/90.

Answer: Did it go away off the Ziac? This could be referred pain from your stomach, but, I can't figure any reason for this drug to cause any GI problems which would feel like a tremor. Occasional patients do have nausea on beta blockers.

Ziac with OJ & Grapefruit Juice [posted 10/9/98]
Question: I have recently been given a beta blocker Ziac but I was recently told by a friend who works at our local hospital that I should not drink orange or grapefruit juice because of a drug interaction I have been drinking a 10 ounce glass of grapefruit juice after every meal to speed up my metabolism for weight loss should I continue to do this my MD is not aware of this claim

Answer: There are drugs which have trouble with grapefruit juice, they generally are the calcium channel blockers and some antifungal drugs. Beta blockers are not affected. By the way, Ziac is a combination of beta blocker and a diuretic-not a pure beta blocker.

Ziac Withdrawal Symptoms [posted 7/23/98]
Question: I was taking Ziac for 3 years and recently stopped taking it 3 months ago. I am currently experiencing nervousness, shakiness and loss of sleep with an increased heart rate that last about 5 minutes (primarily at night when sleeping). Is this something that will go away or should I be back on the medication?

Answer: The rapid heart rate is clearly Ziac withdrawal since this is a drug that tends to slow the heart rate due to the beta blocker in the medication. Nervousness, shakiness, sleeplessness are less common. These may represent a panic attack or anxiety. Beta blockers can be used to treat these conditions, so stopping the Ziac may have brought out an underlying anxiety being treated by the beta blocker part of Ziac. Why did you need to stop? Possibly restarting a small dose of a beta blocker would alleviate these problems.

Ziac - Allergic Reactions to
Question: I have just started taking Ziac. Can it cause an allergic reaction such as rash and some swelling on the face?

Answer: Yes, usually through allergies to the diuretic part of the Ziac (part beta blocker and part diuretic). The diuretic commonly produces a rash, skin sensitivity etc., as a manifestation of its allergy.

Ziac and Diovan
Question: What are the known side effects of these two medications? I have been experiencing headaches, memory loss, loss of energy and fatigue. I was wondering if these are side effects of ziac or diovan.

Answer: Ziac is a combination of a small dose of a beta blocker and a small dose of a diuretic. This is to avoid the side effects of either while lowering Blood Pressure. However, some patients will experience the side effects anyway, especially the beta blocker. These are fatigue, nausea, sleep disturbances and slow pulse. Diuretics can produce low potassium, muscle cramps, impotence, etc. I'm not sure what Diovan is.

Ziac
Question: I am taking 5 mg of ziac everyday. Will I have to continue this medication indefinitely? I am 65 years old.

Answer: Ziac is a combination drug combining a small amount of a beta-blocker and a small amount of a diuretic. This is an attempt to get effectiveness of the two drugs while minimizing the side effects. This seems to work fairly well. You will need to be on this drug unless your blood pressure improves (weight loss) or you have trouble with the side effects of either. For the beta-blocker the side effects tend to be fatigue, depression, and slow pulse. For the diuretic, usually a low potassium or sodium level.

Side Effects
Question: What are the side effects of ZIAC?

Answer: Ziac is a combination of a small amount of a beta-blocker and a small amount of a diuretic. This is in an attempt to achieve the benefits of both while minimizing the side effects. However, some patients will still experience side effects. Side effects of beta-blockers are fatigue, slow pulse, dyspnea(shortness of breath), nightmares and general sleep disturbance. Side effects of diuretics are usually low potassium leading to muscle cramps, rash and allergic side effects, elevated glucose and/or cholesterol.



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