Prescription medicine
Bisoprolol and hydrochlorothiazide First approved as Ziac
Bisoprolol and hydrochlorothiazide (Ziac) is a prescription medicine with an FDA approval on record since 1993. FDA's NDC Directory lists it from 11 generic labelers, and pharmacies paid $0.209 per bisoprolol-hydrochlorothiazide 10-6.25 mg tablet in the October 7, 2026 NADAC survey.
- Generic listed
Check it at the source: the bisoprolol and hydrochlorothiazide FDA label on DailyMed (effective August 11, 2026, Teva Pharmaceuticals USA, Inc.); the NDA 20186 record on Drugs@FDA; every bisoprolol and hydrochlorothiazide label on DailyMed.
Highlights of the record
FDA label of August 11, 2026; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026; NADAC October 7, 2026
Used for
From the label: indications and usageBisoprolol fumarate and hydrochlorothiazide tablets are indicated in the management of hypertension.
Forms and strengths
- 2.5 mg / 6.25 mg
- 5 mg / 6.25 mg
- 6.25 mg / 5 mg
- 6.25 mg / 2.5 mg
- 6.25 mg / 10 mg
- 10 mg / 6.25 mg
Film-coated tablet; tablet.
On the market
- Earliest approval on file
- March 26, 1993 Ziac, Teva Branded Pharm; Drugs@FDA’s file, where older or withdrawn approvals can be missing
- Generic approvals
- 15 first September 25, 2000; 9 with a marketed status in Drugs@FDA
- Labelers listed (NDC)
- 12 of which 11 under generic applications, 0 under brand applications, repackagers included
Supply and safety
- Pharmacy cost (NADAC)
- $0.209 per tablet Bisoprolol-hydrochlorothiazide 10-6.25 mg tablet
- Shortage (FDA)
- No current entry
- Recalls by its makers (FDA)
- 4 since 2021 0 Class I among all firms' recalls; latest January 21, 2026
- FAERS reports
- 614 through July 30, 2026
What is bisoprolol and hydrochlorothiazide used for?
From the label: indications and usageBisoprolol fumarate and hydrochlorothiazide tablets are indicated in the management of hypertension.
Conditions named in the indications of bisoprolol and hydrochlorothiazide's FDA labels, with every medicine labeled for each:
From other bisoprolol and hydrochlorothiazide labelsHigh blood pressure: INDICATIONS AND USAGE Bisoprolol fumarate and hydrochlorothiazide tablets are indicated in the management of hypertension.
FDA pharmacologic class: Thiazide Diuretic and beta-Adrenergic Blocker.
Source: FDA drug label (bisoprolol fumarate and hydrochlorothiazide), Teva Pharmaceuticals USA, Inc., effective August 11, 2026 (SPL set 27d52b23-e3e2-4339-b00e-cd0fec43ffbb), via openFDA; the full label on DailyMed
Is there a generic for bisoprolol and hydrochlorothiazide (Ziac)?
The FDA approved the first generic bisoprolol and hydrochlorothiazide on September 25, 2000. 15 generic applications are approved; 9 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.
FDA's NDC Directory lists bisoprolol and hydrochlorothiazide from 11 labelers under a generic (ANDA) application. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.
- 1993 earliest approval on file
- 2000 first generic approved
- red ticks recalls
Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)
What do pharmacies pay for bisoprolol and hydrochlorothiazide (Ziac)?
In CMS's NADAC survey of October 7, 2026, pharmacies paid $0.209 per Bisoprolol-hydrochlorothiazide 10-6.25 mg tablet, up 3% from $0.204 on October 8, 2025. The chart's scale runs from the lowest to the highest price shown, not from zero. NADAC is what retail pharmacies paid their wholesalers, per unit, in CMS's monthly survey; what a patient pays depends on insurance and the pharmacy.
- Bisoprolol-hydrochlorothiazide 10-6.25 mg tablet (generic)
| Strength and form | Brand or generic | Pharmacy cost | 30 tablets, or one pen or vial | 12-month change |
|---|---|---|---|---|
| Bisoprolol-hydrochlorothiazide 10-6.25 mg tablet | Generic | $0.209 per tablet | $6.28 | +3% |
| Bisoprolol-hydrochlorothiazide 2.5-6.25 mg tablet | Generic | $0.213 per tablet | $6.40 | +3% |
| Bisoprolol-hydrochlorothiazide 5-6.25 mg tablet | Generic | $0.220 per tablet | $6.61 | +11% |
Source: CMS National Average Drug Acquisition Cost (NADAC) survey, October 7, 2026: what retail pharmacies paid per unit; not a counter price
Has bisoprolol and hydrochlorothiazide been recalled?
The FDA's Enforcement Report lists 4 recalls naming bisoprolol and hydrochlorothiazide since 2021: 0 Class I (the most serious), 2 Class II, 2 Class III; 2 still ongoing. A recall names products and lots, not every product of the medicine.
| Started | Class | Company | Reason |
|---|---|---|---|
| January 21, 2026 | Class II | Unichem Pharmaceuticals USA Inc. | cGMP Deviations: recall due to not meeting the N-Nitroso Bisoprolol impurity specification limits. |
| November 21, 2025 | Class III | Glenmark Pharmaceuticals Inc., USA | Cross Contamination with Other Products: Testing of reserve samples showed presence of traces of ezetimibe |
| October 20, 2023 | Class III | Glenmark Pharmaceuticals Inc., USA | Failed Impurities/Degradation Specifications |
| March 15, 2021 | Class II | Cardinal Health Inc. | CGMP Deviations: Intermittent exposure to temperature excursion during storage. |
Source: FDA Enforcement Report (drug recalls) via openFDA, through October 8, 2026
What does the bisoprolol and hydrochlorothiazide label say about other medicines?
The bisoprolol and hydrochlorothiazide label names 4 other medicines in its interaction, contraindication or warning sections. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.
| Medicine named | Section | What the label says |
|---|---|---|
| Clonidine | drug interactions | In patients receiving concurrent therapy with clonidine, if therapy is to be discontinued, it is suggested that bisoprolol fumarate and hydrochlorothiazide tablets be discontinued for several days before the withdrawal of clonidine. |
| Diltiazem | drug interactions | Bisoprolol fumarate and hydrochlorothiazide tablets should be used with caution when myocardial depressants or inhibitors of AV conduction, such as certain calcium antagonists (particularly of the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes), or antiarrhythmic agents, such as disopyramide, are … |
| Disopyramide | drug interactions | … the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes), or antiarrhythmic agents, such as disopyramide, are used concurrently. |
| Verapamil | drug interactions | Bisoprolol fumarate and hydrochlorothiazide tablets should be used with caution when myocardial depressants or inhibitors of AV conduction, such as certain calcium antagonists (particularly of the phenylalkylamine [verapamil] and benzothiazepine [diltiazem] classes), or antiarrhythmic agents, such as disopyramide, are … |
Check bisoprolol and hydrochlorothiazide against other medicines
Source: FDA drug label (bisoprolol fumarate and hydrochlorothiazide), Teva Pharmaceuticals USA, Inc., effective August 11, 2026 (SPL set 27d52b23-e3e2-4339-b00e-cd0fec43ffbb), via openFDA; the full label on DailyMed
What do FAERS reports show for bisoprolol and hydrochlorothiazide?
The FDA Adverse Event Reporting System holds 614 reports that list bisoprolol and hydrochlorothiazide among the medicines taken, through July 30, 2026, each a report of something that happened, not proof the medicine caused it; 53 are coded as a death and 262 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is.
Reports received each year
The most reported reactions
Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026
What else is labeled for the same conditions as bisoprolol and hydrochlorothiazide?
59 other medicines are given the same way (oral) and in the same FDA class as bisoprolol and hydrochlorothiazide or labeled mainly for the same use (high blood pressure), the same class first. High blood pressure lists all 88 medicines labeled for it, by any route. The first 8 are below. They are listed as records, not as substitutes: whether one can replace another is a prescriber's decision.
| Medicine | Shared indication | Generic labelers (oral) | Pharmacy cost | Shortage |
|---|---|---|---|---|
| Metoprolol | High blood pressure | 64 labelers | $0.085 per tablet 100 mg tablet | A presentation being discontinued |
| Propranolol | High blood pressure | 38 labelers | $0.0493 per tablet 20 mg tablet | In shortage |
| Carvedilol | High blood pressure | 41 labelers | $0.0179 per tablet 6.25 mg tablet | No current entry |
| Atenolol | High blood pressure | 35 labelers | $0.0217 per tablet 25 mg tablet | No current entry |
| Labetalol | High blood pressure | 31 labelers | $0.215 per tablet 300 mg tablet | No current entry |
| Nebivolol | High blood pressure | 23 labelers | $0.141 per tablet 10 mg tablet | A presentation being discontinued |
| Nadolol | High blood pressure | 16 labelers | $0.147 per tablet 20 mg tablet | No current entry |
| Pindolol | High blood pressure | 8 labelers | $0.854 per tablet 10 mg tablet | A presentation being discontinued |
Every medicine labeled for the same conditions as bisoprolol and hydrochlorothiazide
Source: FDA drug labels (indications), NDC Directory, NADAC of October 7, 2026, FDA shortages (October 8, 2026)
What next?
- Alternatives to bisoprolol and hydrochlorothiazide
- 59 medicines for the same use
- Other thiazide diuretics
- the pharmacologic class, with prices and generics
- Bisoprolol and hydrochlorothiazide side effects
- the label's list beside FAERS reports
- Check an interaction
- what two or more labels say about each other