Bisoprolol and hydrochlorothiazide interactions

Bisoprolol and hydrochlorothiazide (Ziac), a beta blocker has 300 documented interactions across the FDA labels and fact sheets we index: 28 major, 235 moderate, 35 minor, and 2 where a label reports no significant interaction. Each entry below quotes the sentence behind it. This drug page is a starting point, not a verdict for your situation.

Major interactions (28)

  • Acetazolamidecarbonic anhydrase inhibitorMajor

    CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

  • Amiloridepotassium-sparing diureticMajor

    Hyperkalemia occurs commonly (about 10%) when amiloride is used without a kaliuretic diuretic. (Amiloride label, Boxed warning)

  • Bumetanideloop diureticMajor

    WARNING Bumetanide is a potent diuretic which, if given in excessive amounts, can lead to a profound diuresis with water and electrolyte depletion. (Bumetanide label, Boxed warning)

  • ClozapineantipsychoticMajor

    Use CLOZARIL cautiously in patients with cardiovascular or cerebrovascular disease or conditions predisposing to hypotension (e.g., dehydration, use of antihypertensive medications) [see Dosage and Administration ( 2.2 , 2.6 ), Warnings and Precautions ( 5.2 )]. (Clozapine label, Boxed warning)

  • CyclosporineimmunosuppressantMajor

    Potassium-Sparing Diuretics Cyclosporine should not be used with potassium-sparing diuretics because hyperkalemia can occur. (Cyclosporine label, Drug interactions)

  • Diltiazemcalcium channel blockerMajor

    • Concomitant administration with IV beta-blockers. (Diltiazem label, Contraindications)

  • DofetilideantiarrhythmicMajor

    The concomitant use of hydrochlorothiazide (alone or in combinations such as with triamterene) with dofetilide is contraindicated (see PRECAUTIONS, Drug-Drug Interactions ) because this has been shown to significantly increase dofetilide plasma concentrations and QT interval prolongation. (Dofetilide label, Contraindications)

  • Dorzolamidecarbonic anhydrase inhibitorMajor

    CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

  • Dorzolamide and timololcarbonic anhydrase inhibitorMajor

    CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

  • Eplerenonealdosterone antagonistMajor

    …• serum creatinine > 2.0 mg/dL in males or >1.8 mg/dL in females, • creatinine clearance < 50 mL/min, or • concomitant administration of potassium supplements or potassium-sparing diuretics (e.g., amiloride, spironolactone, or triamterene) [see Warnings and Precautions (5.1) , Adverse Reactions (6.2) , Drug Interactions (7) , and Clinical Pharmacology (12.3)… (Eplerenone label, Contraindications)

  • Ethacrynic acidloop diureticMajor

    CONTRAINDICATIONS All diuretics, including ethacrynic acid, are contraindicated in anuria. (Ethacrynic acid label, Contraindications)

  • FlecainideantiarrhythmicMajor

    Concomitant negative chronotropic therapy such as digoxin or beta-blockers may lower the risk of this complication. (Flecainide label, Boxed warning)

  • GentamicinaminoglycosideMajor

    The concurrent use of gentamicin with potent diuretics, such as ethacrynic acid or furosemide, should be avoided, since certain diuretics by themselves may cause ototoxicity. (Gentamicin label, Boxed warning)

  • Itraconazoleazole antifungalMajor

    Diuretics Eplerenone Contraindicated during and 2 weeks after TOLSURA treatment. (Itraconazole label, Drug interactions)

  • Metolazonethiazide diureticMajor

    Other Antihypertensive Drugs When metolazone tablets, USP, are used with other antihypertensive drugs, particular care must be taken to avoid excessive reduction of blood pressure, especially during initial therapy. (Metolazone label, Warnings)

  • MinoxidilvasodilatorMajor

    Minoxidil should be reserved for hypertensive patients who do not respond adequately to maximum therapeutic doses of a diuretic and two other antihypertensive agents. (Minoxidil label, Boxed warning)

  • Nebivololbeta blockerMajor

    Hypotensive Agents Do not use BYSTOLIC with other β-blockers. (Nebivolol label, Drug interactions)

  • NeomycinaminoglycosideMajor

    The concurrent use of neomycin with potent diuretics such as ethacrynic acid or furosemide should be avoided, since certain diuretics by themselves may cause ototoxicity. (Neomycin label, Boxed warning)

  • QuinaprilACE inhibitorMajor

    …sometimes associated with oliguria and/or progressive azotemia, and rarely with acute renal failure and/or death, include patients with the following conditions or characteristics: heart failure, hyponatremia, high dose diuretic therapy, recent intensive diuresis or increase in diuretic dose, renal dialysis, or severe volume and/or salt depletion of any etiology. (Quinapril label, Warnings)

  • RepaglinidemeglitinideMajor

    Examples: beta-blockers, clonidine, guanethidine, and reserpine Clopidogrel : Avoid concomitant use; if used concomitantly initiate at 0.5 mg before each meal and limit total daily dose to 4 mg ( 7 ) (Repaglinide label, Drug interactions)

  • Rivastigminecholinesterase inhibitorMajor

    Concomitant use with metoclopramide, beta-blockers, or cholinomimetic and anticholinergic drugs is not recommended ( 7.1 , 7.2 , 7.3 ) (Rivastigmine label, Drug interactions)

  • Silver sulfadiazinesulfonamideMajor

    CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

  • Sodium bicarbonateantacidMajor

    Sodium bicarbonate injection is contraindicated in patients who are losing chloride by vomiting or from continuous gastrointestinal suction and in patients receiving diuretics known to produce a hypochloremic alkalosis. (Sodium bicarbonate label, Contraindications)

  • CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

  • SulfasalazinesulfonamideMajor

    CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

  • TadalafilPDE5 inhibitorMajor

    …coadministration of an alpha-blocker and CIALIS for the treatment of BPH has not been adequately studied, and due to the potential vasodilatory effects of combined use resulting in blood pressure lowering, the combination of CIALIS and alpha-blockers is not recommended for the treatment of BPH. [see Dosage and Administration ( 2.7 ), Drug Interactions ( 7.1 ),… (Tadalafil label, Warnings and precautions)

  • TranylcypromineMAO inhibitorMajor

    …Syndrome (SS) c ] Agents with blood pressure-reducing effects Use with caution d Hypotension e Non-selective H1 receptor antagonists Contraindicated a Increased anticholinergic effects Beta-adrenergic blockers (see also agents or procedures with blood pressure-reducing effects) Use with the caution d More pronounced bradycardia, postural hypotension e Blood glucose-lowering… (Tranylcypromine label, Drug interactions)

  • ZonisamideanticonvulsantMajor

    CONTRAINDICATIONS Bisoprolol fumarate and hydrochlorothiazide tablets are contraindicated in patients in cardiogenic shock, overt cardiac failure (see WARNINGS ), second or third degree AV block, marked sinus bradycardia, anuria, and hypersensitivity to either component of this product or to other sulfonamide-derived drugs. (Bisoprolol and hydrochlorothiazide label, Contraindications)

Moderate interactions (235)

  • AcarboseantidiabeticModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Albuterolbeta-adrenergic agonistModerate

    Beta-blockers: Use with caution. (Albuterol label, Drug interactions)

  • AlcoholAlcoholModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Alfuzosinalpha blockerModerate

    Postural hypotension/syncope: Care should be taken in patients with symptomatic hypotension or who have had a hypotensive response to other medications or are concomitantly treated with antihypertensive medication or nitrates ( 5.1 ) (Alfuzosin label, Warnings and precautions)

  • AliskirenantihypertensiveModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Allopurinolxanthine oxidase inhibitorModerate

    Hypersensitivity reactions to allopurinol tablets may be increased in patients with decreased kidney function receiving thiazide diuretics and allopurinol tablets concurrently. (Allopurinol label, Warnings and precautions)

  • AmiodaroneantiarrhythmicModerate

    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 used concurrently. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Amlodipinedihydropyridine calcium channel blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Amlodipine and benazeprildihydropyridine calcium channel blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Amoxicillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Amoxicillin and clavulanatepenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Ampicillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • AripiprazoleantipsychoticModerate

    Antihypertensive Drugs Due to its alpha-adrenergic antagonism, aripiprazole has the potential to enhance the effect of certain antihypertensive agents. (Aripiprazole label, Drug interactions)

  • ArmodafinilCNS stimulantModerate

    There was also a slightly greater proportion of patients on NUVIGIL requiring new or increased use of antihypertensive medications (2.9%) compared to patients on placebo (1.8%). (Armodafinil label, Warnings and precautions)

  • AsenapineantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medications, patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Asenapine label, Warnings and precautions)

  • AspirinNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Aspirin and dipyridamoleantiplatelet agentModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Atenololbeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Atomoxetinenorepinephrine reuptake inhibitorModerate

    Antihypertensive Drugs Prevention or Management Increase the frequency of monitoring blood pressure and adjust atomoxetine oral solution dosage as clinically appropriate. (Atomoxetine label, Drug interactions)

  • AvanafilPDE5 inhibitorModerate

    • Use of avanafil with alpha-blockers, other antihypertensives, or substantial amounts of alcohol (greater than 3 units) may lead to hypotension ( 2.3 , 5.6 , 5.7 ) (Avanafil label, Warnings and precautions)

  • Azilsartanangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Baclofenmuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine) - possible increased responsiveness to the muscle relaxant. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • BenazeprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Bisoprololbeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • BrexpiprazoleantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, concomitant treatment with antihypertensive medication), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Brexpiprazole label, Warnings and precautions)

  • Brimonidinealpha-adrenergic agonistModerate

    Antihypertensives/Cardiac Glycosides Because brimonidine tartrate ophthalmic solution 0.1% and 0.15% may reduce blood pressure, caution in using drugs such as antihypertensives and/or cardiac glycosides with brimonidine tartrate ophthalmic solution 0.1% and 0.15% is advised. (Brimonidine label, Drug interactions)

  • Budesonide and formoterolcorticosteroidModerate

    Beta-blockers: Use with caution. (Budesonide and formoterol label, Drug interactions)

  • BuprenorphineopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Buprenorphine and naloxoneopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • BupropionantidepressantModerate

    Drugs Metabolized by CYP2D6: Bupropion inhibits CYP2D6 and can increase concentrations of: antidepressants (e.g., venlafaxine, nortriptyline, imipramine, desipramine, paroxetine, fluoxetine, sertraline), antipsychotics (e.g., haloperidol, risperidone, thioridazine), beta-blockers (e.g., metoprolol), and Type 1C antiarrhythmics (e.g., propafenone, flecainide). (Bupropion label, Drug interactions)

  • Butalbital, acetaminophen, and caffeinebarbiturateModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • ButorphanolopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Calcitriolvitamin D analogModerate

    Thiazides Thiazides are known to induce hypercalcemia by the reduction of calcium excretion in urine. (Calcitriol label, Drug interactions)

  • CanagliflozinSGLT2 inhibitorModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Candesartanangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • CaptoprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • CarbamazepineanticonvulsantModerate

    Elderly patients and patients treated with diuretics are at greater risk of developing hyponatremia. (Carbamazepine label, Warnings and precautions)

  • Carbidopa and levodopadopaminergic drugModerate

    Antihypertensive drugs: May cause symptomatic postural hypotension. (Carbidopa and levodopa label, Drug interactions)

  • CariprazineantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Cariprazine label, Warnings and precautions)

  • Carisoprodolmuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine) - possible increased responsiveness to the muscle relaxant. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Carvedilolbeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • CelecoxibNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Cevimelinecholinergic agonistModerate

    DRUG INTERACTIONS Cevimeline should be administered with caution to patients taking beta adrenergic antagonists, because of the possibility of conduction disturbances. (Cevimeline label, Drug interactions)

  • ChlorpromazineantipsychoticModerate

    Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Chlorpromazine label, Precautions)

  • Chlorthalidonethiazide diureticModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Cholestyraminebile acid sequestrantModerate

    Single doses of cholestyramine and colestipol resins bind the hydrochlorothiazide and reduce its absorption in the gastrointestinal tract by up to 85 percent and 43 percent, respectively. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • CitalopramSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume depleted may be at greater risk for developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Citalopram label, Warnings and precautions)

  • Clonidinealpha-adrenergic agonistModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • CodeineopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Cyclobenzaprinemuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine) - possible increased responsiveness to the muscle relaxant. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Dantrolenemuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine) - possible increased responsiveness to the muscle relaxant. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • DapagliflozinSGLT2 inhibitorModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • DesmopressinModerate

    …Hyponatremia Concomitant administration of DESMODA with other drugs that may increase the risk of water intoxication with hyponatremia, (e.g., tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine, opiate analgesics, thiazide diuretics, NSAIDs, lamotrigine, sulfonylureas, particularly chlorpropamide, oxybutynin and carbamazepine). (Desmopressin label, Drug interactions)

  • DesvenlafaxineSNRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk [see Use in Specific Populations (8.5) and Clinical Pharmacology (12.3) ] . (Desvenlafaxine label, Warnings and precautions)

  • DeutetrabenazineVMAT2 inhibitorModerate

    Patients receiving catecholamine-depleting drugs, such as reserpine or guanethidine, should be closely monitored because the added beta-adrenergic blocking action of bisoprolol fumarate may produce excessive reduction of sympathetic activity. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Dexlansoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Dexlansoprazole label, Warnings and precautions)

  • DexmethylphenidateCNS stimulantModerate

    Antihypertensive Drugs: Monitor blood pressure. (Dexmethylphenidate label, Drug interactions)

  • DiclofenacNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Dicloxacillinpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Digoxindigitalis glycosideModerate

    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 used concurrently. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Dihydroergotamineergot alkaloidModerate

    Beta Blockers Although the results of a clinical study did not indicate a safety problem associated with the administration of Dihydroergotamine Mesylate Injection, USP to subjects already receiving propranolol, there have been reports that propranolol may potentiate the vasoconstrictive action of ergotamine by blocking the vasodilating property of epinephrine. (Dihydroergotamine label, Drug interactions)

  • Doxazosinalpha blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • DronedaroneantiarrhythmicModerate

    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 used concurrently. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Drospirenone and ethinyl estradioloral contraceptiveModerate

    Medications that may increase serum potassium concentration include ACE inhibitors, angiotensin-II receptor antagonists, potassium-sparing diuretics, potassium supplementation, heparin, aldosterone antagonists, and NSAIDS. (Drospirenone and ethinyl estradiol label, Warnings and precautions)

  • DulaglutideGLP-1 receptor agonistModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • DuloxetineSNRIModerate

    The risk of BP decreases may be greater in patients taking concomitant medications that induce orthostatic hypotension (such as antihypertensives) or are potent CYP1A2 inhibitors [see Warnings and Precautions ( 5.12 ) and Drug Interactions ( 7.1 )] and in patients taking CYMBALTA at doses above 60 mg daily. (Duloxetine label, Warnings and precautions)

  • EluxadolineopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • EmpagliflozinSGLT2 inhibitorModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Empagliflozin and metforminSGLT2 inhibitorModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • EnalaprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • EpinephrinesympathomimeticModerate

    Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reactions. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Epoetin alfaModerate

    Following initiation and titration of Epogen, approximately 25% of patients on dialysis required initiation of or increases in antihypertensive therapy; hypertensive encephalopathy and seizures have been reported in patients with CKD receiving Epogen. (Epoetin alfa label, Warnings and precautions)

  • EscitalopramSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Escitalopram label, Warnings and precautions)

  • Esmololbeta blockerModerate

    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 used concurrently. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Esomeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Esomeprazole label, Warnings and precautions)

  • EtodolacNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • ExenatideGLP-1 receptor agonistModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Felodipinedihydropyridine calcium channel blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • FentanylopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Fluconazoleazole antifungalModerate

    Hydrochlorothiazide In a pharmacokinetic interaction study, coadministration of multiple-dose hydrochlorothiazide to healthy volunteers receiving fluconazole increased plasma concentrations of fluconazole by 40%. (Fluconazole label, Drug interactions)

  • FludrocortisonecorticosteroidModerate

    Amphotericin B or potassium-depleting diuretics (benzothiadiazines and related drugs, ethacrynic acid and furosemide)—enhanced hypokalemia. (Fludrocortisone label, Drug interactions)

  • FluoxetineSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Fluoxetine label, Warnings and precautions)

  • Fluticasone and salmeterolcorticosteroidModerate

    Diuretics: Use with caution. (Fluticasone and salmeterol label, Drug interactions)

  • FluvoxamineSSRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted may be at greater risk. (Fluvoxamine label, Warnings and precautions)

  • Formoterolbeta-adrenergic agonistModerate

    • Xanthine derivatives, steroids, diuretics, or non-potassium sparing diuretics may potentiate hypokalemia or ECG changes. (Formoterol label, Drug interactions)

  • FosinoprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Furosemideloop diureticModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • GlimepiridesulfonylureaModerate

    Beta-blockers may further increase the risk of severe hypoglycemia when used concurrently with sulfonylureas. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • GlipizidesulfonylureaModerate

    Beta-blockers may further increase the risk of severe hypoglycemia when used concurrently with sulfonylureas. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • GlucagonModerate

    Table 4: Clinically Significant Drug Interaction with GVOKE and GVOKE VialDx Beta-Blockers Clincial Impact: Patients taking beta-blockers may have a transient increase in pulse and blood pressure when given GVOKE or GVOKE VialDx. (Glucagon label, Drug interactions)

  • GlyburidesulfonylureaModerate

    Beta-blockers may further increase the risk of severe hypoglycemia when used concurrently with sulfonylureas. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Glyburide and metforminsulfonylureaModerate

    Beta-blockers may further increase the risk of severe hypoglycemia when used concurrently with sulfonylureas. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Guanfacinealpha-adrenergic agonistModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • HaloperidolantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are at risk for hypotension (e.g., geriatric patients, patients with dehydration, hypovolemia, and concomitantly treated with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Haloperidol label, Warnings and precautions)

  • HydralazinevasodilatorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Hydrochlorothiazidethiazide diureticModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Hydrocodone and acetaminophenopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • HydromorphoneopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • IbuprofenNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • IloperidoneantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive medications), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and… (Iloperidone label, Warnings and precautions)

  • Indapamidethiazide diureticModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • IndomethacinNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Insulin aspartinsulinModerate

    Also, latent diabetes mellitus may become manifest and diabetic patients given thiazides may require adjustment of their insulin dose. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Insulin degludecinsulinModerate

    Also, latent diabetes mellitus may become manifest and diabetic patients given thiazides may require adjustment of their insulin dose. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Insulin detemirinsulinModerate

    Also, latent diabetes mellitus may become manifest and diabetic patients given thiazides may require adjustment of their insulin dose. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Insulin glargineinsulinModerate

    Also, latent diabetes mellitus may become manifest and diabetic patients given thiazides may require adjustment of their insulin dose. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Insulin lisproinsulinModerate

    Also, latent diabetes mellitus may become manifest and diabetic patients given thiazides may require adjustment of their insulin dose. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Insulin regular (human)insulinModerate

    Also, latent diabetes mellitus may become manifest and diabetic patients given thiazides may require adjustment of their insulin dose. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Irbesartanangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Isosorbide dinitrate and hydralazinenitrateModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Isradipinedihydropyridine calcium channel blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • IvabradineModerate

    The risk of bradycardia increases with concomitant administration of drugs that slow heart rate (e.g., digoxin, amiodarone, beta-blockers). (Ivabradine label, Drug interactions)

  • Ketoconazoleazole antifungalModerate

    Antivirals indinavir, maraviroc, saquinavir Beta Blockers nadolol Calcium Channel Blockers felodipine, nisoldipine other dihydropyridines, verapamil Calcium channel blockers can have a negative inotropic effect which may be additive to those of ketoconazole. (Ketoconazole label, Drug interactions)

  • KetorolacNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Labetalolbeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • LacosamideanticonvulsantModerate

    VIMPAT should also be used with caution in patients on concomitant medications that affect cardiac conduction, including sodium channel blockers, beta-blockers, calcium channel blockers, potassium channel blockers, and medications that prolong the PR interval [see Drug Interactions (7.2) ] . (Lacosamide label, Warnings and precautions)

  • Lansoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ] . (Lansoprazole label, Warnings and precautions)

  • Levalbuterolbeta-adrenergic agonistModerate

    In this setting, cardioselective beta-blockers should be considered, although they should be administered with caution. (Levalbuterol label, Drug interactions)

  • LevomilnacipranSNRIModerate

    Also, patients taking diuretics or who are otherwise volume depleted can be at greater risk. (Levomilnacipran label, Warnings and precautions)

  • LevorphanolopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Levothyroxinethyroid hormoneModerate

    Laboratory Test Interactions Based on reports involving thiazides, bisoprolol fumarate and hydrochlorothiazide tablets may decrease serum levels of protein-bound iodine without signs of thyroid disturbance. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Lidocainelocal anestheticModerate

    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 used concurrently. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Lidocaine and prilocainelocal anestheticModerate

    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 used concurrently. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • LinagliptinDPP-4 inhibitorModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • LinezolidantibioticModerate

    Monitor serum sodium levels regularly in the elderly, in patients taking diuretics, and in other patients at risk of hyponatremia and/or SIADH while taking Linezolid injection. (Linezolid label, Warnings and precautions)

  • Liothyroninethyroid hormoneModerate

    Laboratory Test Interactions Based on reports involving thiazides, bisoprolol fumarate and hydrochlorothiazide tablets may decrease serum levels of protein-bound iodine without signs of thyroid disturbance. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • LiraglutideGLP-1 receptor agonistModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • LisinoprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Lisinopril and hydrochlorothiazideACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Lithiumserotonergic drugModerate

    Diuretic agents reduce the renal clearance of lithium and add a high risk of lithium toxicity. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Lofexidinealpha-adrenergic agonistModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Losartanangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Losartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • LumateperoneantipsychoticModerate

    Orthostatic vital signs should be monitored in patients who are vulnerable to hypotension (e.g., elderly patients, patients with dehydration, hypovolemia, and concomitant treatment with antihypertensive drugs), patients with known cardiovascular disease (history of myocardial infarction, ischemic heart disease, heart failure, or conduction abnormalities), and patients… (Lumateperone label, Warnings and precautions)

  • LurasidoneantipsychoticModerate

    Patients at increased risk of these adverse reactions or at increased risk of developing complications from hypotension include those with dehydration, hypovolemia, treatment with antihypertensive medication, history of cardiovascular disease (e.g., heart failure, myocardial infarction, ischemia, or conduction abnormalities), history of cerebrovascular disease,… (Lurasidone label, Warnings and precautions)

  • MeloxicamNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • MeperidineopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • MetforminbiguanideModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • MethadoneopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Methimazoleantithyroid drugModerate

    Laboratory Test Interactions Based on reports involving thiazides, bisoprolol fumarate and hydrochlorothiazide tablets may decrease serum levels of protein-bound iodine without signs of thyroid disturbance. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Methocarbamolmuscle relaxantModerate

    Skeletal muscle relaxants, nondepolarizing (e.g., tubocurarine) - possible increased responsiveness to the muscle relaxant. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • MethyldopaantihypertensiveModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • MethylphenidateCNS stimulantModerate

    Antihypertensive Drugs: Monitor blood pressure. (Methylphenidate label, Drug interactions)

  • Metoprololbeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • MirtazapineantidepressantModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia [see Use in Specific Populations (8.5) ] . (Mirtazapine label, Warnings and precautions)

  • ModafinilCNS stimulantModerate

    However, a retrospective analysis of the use of antihypertensive medication in these studies showed that a greater proportion of patients on PROVIGIL required new or increased use of antihypertensive medications (2.4%) compared to patients on placebo (0.7%). (Modafinil label, Warnings and precautions)

  • MoexiprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • MorphineopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • NabumetoneNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Nadololbeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • NalbuphineopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Naltrexone and bupropionopioid antagonistModerate

    Drugs Metabolized by CYP2D6: Bupropion inhibits CYP2D6 and can increase concentrations of antidepressants, (e.g., selective serotonin reuptake inhibitors and many tricyclics), antipsychotics (e.g., haloperidol, risperidone and thioridazine), beta-blockers (e.g., metoprolol) and Type 1C antiarrhythmics (e.g., propafenone and flecainide). (Naltrexone and bupropion label, Drug interactions)

  • NaproxenNSAIDModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • NiacinModerate

    Antihypertensive Therapy Niacin may potentiate the effects of ganglionic blocking agents and vasoactive drugs resulting in postural hypotension. (Niacin label, Drug interactions)

  • Nicardipinedihydropyridine calcium channel blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Nifedipinedihydropyridine calcium channel blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Nisoldipinedihydropyridine calcium channel blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • NitroglycerinnitrateModerate

    Antihypertensives: Possible additive hypotensive effects. (Nitroglycerin label, Drug interactions)

  • OlanzapineantipsychoticModerate

    …of myocardial infarction or ischemia, heart failure, or conduction abnormalities), cerebrovascular disease, and conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications) where the occurrence of syncope, or hypotension and/or bradycardia might put the patient at increased medical risk. (Olanzapine label, Warnings and precautions)

  • OliceridineopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Olmesartanangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Omeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions ( 6.2 )] . (Omeprazole label, Warnings and precautions)

  • OxycodoneopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Oxycodone and acetaminophenopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • OxymorphoneopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • PaliperidoneantipsychoticModerate

    Use ERZOFRI with caution in patients with known cardiovascular disease (e.g., heart failure, history of myocardial infarction or ischemia, conduction abnormalities), cerebrovascular disease, or conditions that predispose the patient to hypotension (e.g., dehydration, hypovolemia, and treatment with antihypertensive medications). (Paliperidone label, Warnings and precautions)

  • Pantoprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Pantoprazole label, Warnings and precautions)

  • ParoxetineSSRIModerate

    Geriatric patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Paroxetine label, Warnings and precautions)

  • Penicillin Gpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Penicillin Vpenicillin antibioticModerate

    Risk factors for developing acute angle-closure glaucoma may include a history of sulfonamide or penicillin allergy. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Pentazocine and naloxoneopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • PentoxifyllinemethylxanthineModerate

    Small decreases in blood pressure have been observed in some patients treated with pentoxifylline extended-release tablets; periodic systemic blood pressure monitoring is recommended for patients receiving concomitant antihypertensive therapy. (Pentoxifylline label, Drug interactions)

  • PerindoprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • PhenelzineMAO inhibitorModerate

    …hydrochloride desipramine hydrochloride imipramine hydrochloride doxepin carbamazepine cyclobenzaprine HCl amoxapine maprotiline HCl trimipramine maleate protriptyline HCl mirtazapine Phenelzine sulfate should be used with caution in combination with antihypertensive drugs, including thiazide diuretics and β-blockers, since exaggerated hypotensive effects may result. (Phenelzine label, Warnings)

  • PhenobarbitalbarbiturateModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Phentermine and topiramateCNS stimulantModerate

    Concomitant administration of hydrochlorothiazide alone with topiramate alone has been shown to increase the C max and AUC of topiramate by 27% and 29%, respectively. (Phentermine and topiramate label, Drug interactions)

  • Pilocarpinecholinergic agonistModerate

    Drug Interactions Pilocarpine should be administered with caution to patients taking beta-adrenergic antagonists because of the possibility of conduction disturbances. (Pilocarpine label, Drug interactions)

  • Pindololbeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • PioglitazonethiazolidinedioneModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Pioglitazone and metforminthiazolidinedioneModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Prazosinalpha blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • PrimidoneanticonvulsantModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • ProchlorperazineantipsychoticModerate

    Thiazide diuretics may accentuate the orthostatic hypotension that may occur with phenothiazines. (Prochlorperazine label, Precautions)

  • PropafenoneantiarrhythmicModerate

    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 used concurrently. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Propranololbeta blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Propylthiouracilantithyroid drugModerate

    Laboratory Test Interactions Based on reports involving thiazides, bisoprolol fumarate and hydrochlorothiazide tablets may decrease serum levels of protein-bound iodine without signs of thyroid disturbance. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Pyridostigminecholinesterase inhibitorModerate

    Use with caution in persons with increased risk of anticholinergic reactions, such as persons with bronchial asthma, chronic obstructive pulmonary disease, bradycardia, cardiac arrhythmias, beta blocker treatment (increased risk of anticholinergic reactions). (Pyridostigmine label, Warnings and precautions)

  • QuetiapineantipsychoticModerate

    Quetiapine should be used with particular caution in patients with known cardiovascular disease (history of myocardial infarction or ischemic heart disease, heart failure, or conduction abnormalities), cerebrovascular disease, or conditions which would predispose patients to hypotension (dehydration, hypovolemia, and treatment with antihypertensive medications). (Quetiapine label, Warnings and precautions)

  • Rabeprazoleproton pump inhibitorModerate

    For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically [see Adverse Reactions (6.2) ]. (Rabeprazole label, Warnings and precautions)

  • RamiprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • RifampinantibioticModerate

    Bisoprolol Fumarate Concurrent use of rifampin increases the metabolic clearance of bisoprolol fumarate, shortening its elimination half-life. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • RiociguatvasodilatorModerate

    Consider the potential for symptomatic hypotension or ischemia in patients with hypovolemia, severe left ventricular outflow obstruction, resting hypotension, autonomic dysfunction, or concomitant treatment with antihypertensives or strong CYP and P-gp/BCRP inhibitors [see Drug Interactions (7.2) and Clinical Pharmacology (12.3) ] . (Riociguat label, Warnings and precautions)

  • RisperidoneantipsychoticModerate

    Clinically significant hypotension has been observed with concomitant use of oral RISPERDAL and antihypertensive medication. (Risperidone label, Warnings and precautions)

  • RitonavirantiretroviralModerate

    The impact on the PR interval of co-administration of ritonavir with other drugs that prolong the PR interval (including calcium channel blockers, beta-adrenergic blockers, digoxin and atazanavir) has not been evaluated. (Ritonavir label, Warnings and precautions)

  • Sacubitril and valsartanangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Salmeterolbeta-adrenergic agonistModerate

    Beta-blockers: Use with caution. (Salmeterol label, Drug interactions)

  • SemaglutideGLP-1 receptor agonistModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • SertralineSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs [see Use in Specific Populations ( 8.5 )] . (Sertraline label, Warnings and precautions)

  • SildenafilPDE5 inhibitorModerate

    Caution is advised when SILDENAFIL ORAL FILM is co-administered with alpha-blockers or antihypertensives. (Sildenafil label, Warnings and precautions)

  • SitagliptinDPP-4 inhibitorModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Sitagliptin and metforminDPP-4 inhibitorModerate

    Antidiabetic drugs (oral agents and insulin) - dosage adjustment of the antidiabetic drug may be required. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Sofosbuvir and velpatasvirantiviralModerate

    Patients also taking beta blockers, or those with underlying cardiac comorbidities and/or advanced liver disease may be at increased risk for symptomatic bradycardia with coadministration of amiodarone. (Sofosbuvir and velpatasvir label, Warnings and precautions)

  • Sotalolbeta blockerModerate

    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 used concurrently. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Spironolactonealdosterone antagonistModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Spironolactone and hydrochlorothiazidealdosterone antagonistModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Sumatriptan and naproxentriptanModerate

    Nonsteroidal anti-inflammatory drugs - In some patients, the administration of a nonsteroidal anti-inflammatory agent can reduce the diuretic, natriuretic, and antihypertensive effects of loop, potassium sparing, and thiazide diuretics. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • TacrolimusimmunosuppressantModerate

    • Hypertension: May require antihypertensive therapy; monitor relevant drug interactions. (Tacrolimus label, Warnings and precautions)

  • TapentadolopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Telmisartanangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Terazosinalpha blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Terbutalinebeta-adrenergic agonistModerate

    In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution. (Terbutaline label, Precautions)

  • TestosteroneandrogenModerate

    In patients with hypertension on antihypertensive therapy, KYZATREX® increased the mean systolic/diastolic BP by 3.4/0.7 mm Hg from baseline after 4 months of treatment and 3.1/1.0 mm Hg from baseline after 6 months of treatment. [see Adverse Reactions (6.1) ]. (Testosterone label, Warnings and precautions)

  • TetrabenazineVMAT2 inhibitorModerate

    Patients receiving catecholamine-depleting drugs, such as reserpine or guanethidine, should be closely monitored because the added beta-adrenergic blocking action of bisoprolol fumarate may produce excessive reduction of sympathetic activity. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • TirzepatideGLP-1 receptor agonistModerate

    Also, latent diabetes mellitus may become manifest and diabetic patients given thiazides may require adjustment of their insulin dose. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Tizanidinemuscle relaxantModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • TobramycinaminoglycosideModerate

    Some diuretics can enhance aminoglycoside toxicity by altering antibiotic concentrations in serum and tissue. (Tobramycin label, Drug interactions)

  • TopiramateanticonvulsantModerate

    Hydrochlorothiazide (HCTZ) Topiramate C max and AUC increased when HCTZ was added to immediate-release topiramate. (Topiramate label, Drug interactions)

  • Torsemideloop diureticModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • TramadolopioidModerate

    Alcohol, barbiturates, or narcotics - potentiation of orthostatic hypotension may occur. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • TrandolaprilACE inhibitorModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • TrazodoneantidepressantModerate

    Concomitant use with an antihypertensive may require a reduction in the dose of the antihypertensive drug. (Trazodone label, Warnings and precautions)

  • Triamterenepotassium-sparing diureticModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Triamterene and hydrochlorothiazidepotassium-sparing diureticModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Umeclidinium and vilanterolanticholinergicModerate

    Beta-blockers: Use with caution. (Umeclidinium and vilanterol label, Drug interactions)

  • ValbenazineVMAT2 inhibitorModerate

    Patients receiving catecholamine-depleting drugs, such as reserpine or guanethidine, should be closely monitored because the added beta-adrenergic blocking action of bisoprolol fumarate may produce excessive reduction of sympathetic activity. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • Valsartanangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Valsartan and hydrochlorothiazideangiotensin II receptor blocker (ARB)Moderate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • VardenafilPDE5 inhibitorModerate

    Vardenafil hydrochloride tablets can potentiate the hypotensive effects of nitrates, alpha- blockers, and antihypertensives. (Vardenafil label, Drug interactions)

  • VenlafaxineSNRIModerate

    Also, patients taking diuretics or who are otherwise volume-depleted may be at greater risk [see Use in Specific Populations ( 8.5 )] . (Venlafaxine label, Warnings and precautions)

  • Verapamilcalcium channel blockerModerate

    Because of the relative beta 1 -selectivity of bisoprolol fumarate, bisoprolol fumarate and hydrochlorothiazide tablets may be used with caution in patients with bronchospastic disease who do not respond to, or who cannot tolerate other antihypertensive treatment. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • VilazodoneSSRIModerate

    Elderly patients, patients taking diuretics, and those who are volume-depleted may be at greater risk of developing hyponatremia with SSRIs and SNRIs [see Use in Specific Populations ( 8.5 )] . (Vilazodone label, Warnings and precautions)

  • Vitamin DVitamin and mineralModerate

    Thiazide diuretics reduce calcium excretion; combined with vitamin D and calcium supplements this can lead to hypercalcemia, especially in older adults. (NIH Office of Dietary Supplements, Vitamin D)

  • VortioxetineantidepressantModerate

    Also, patients taking diuretics or who are otherwise volume-depleted can be at greater risk. (Vortioxetine label, Warnings and precautions)

  • WarfarinanticoagulantModerate

    There was no effect of bisoprolol fumarate on prothrombin times in patients on stable doses of warfarin. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • ZiprasidoneantipsychoticModerate

    Hypokalemia may result from diuretic therapy, diarrhea, and other causes. (Ziprasidone label, Warnings and precautions)

Minor mentions (35)

  • AclidiniumanticholinergicMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • AmbrisentanMinor

    Patients required intervention with a diuretic, fluid management, or, in some cases, hospitalization for decompensating heart failure. (Ambrisentan label, Warnings and precautions)

  • BeclomethasonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • BetamethasonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • BosentanCYP3A4 inducerMinor

    Patients required intervention with a diuretic, fluid management, or hospitalization for decompensating heart failure. (Bosentan label, Warnings and precautions)

  • BudesonidecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • CalciumVitamin and mineralMinor

    Thiazide diuretics reduce calcium excretion, so high calcium intake can raise blood calcium. (NIH Office of Dietary Supplements, Calcium)

  • ClobetasolcorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • DesonidecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • DexamethasonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Febuxostatxanthine oxidase inhibitorMinor

    In Vivo Drug Interaction Studies Based on drug interaction studies in healthy patients, ULORIC does not have clinically significant interactions with colchicine, naproxen, indomethacin, hydrochlorothiazide, warfarin or desipramine [see Clinical Pharmacology (12.3) ]. (Febuxostat label, Drug interactions)

  • Finasteride5-alpha reductase inhibitorMinor

    …PROSCAR was concomitantly used in clinical studies with acetaminophen, acetylsalicylic acid, α-blockers, angiotensin-converting enzyme (ACE) inhibitors, analgesics, anti-convulsants, beta-adrenergic blocking agents, diuretics, calcium channel blockers, cardiac nitrates, HMG-CoA reductase inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines,… (Finasteride label, Drug interactions)

  • FingolimodimmunosuppressantMinor

    Drugs That Slow Heart Rate or Atrioventricular Conduction (e.g., beta blockers or diltiazem) Experience with GILENYA in patients receiving concurrent therapy with drugs that slow the heart rate or AV conduction (e.g., beta blockers, digoxin, or heart rate-slowing calcium channel blockers, such as diltiazem or verapamil) is limited. (Fingolimod label, Drug interactions)

  • FluocinonidecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • FluticasonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • HalobetasolcorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • HydrocortisonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • ImatinibCYP3A4 inhibitorMinor

    Weigh patients regularly and manage unexpected rapid weight gain by drug interruption and diuretics. (Imatinib label, Warnings and precautions)

  • IpratropiumanticholinergicMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • MacitentanMinor

    Postmarketing cases of edema and fluid retention occurring within weeks of starting OPSUMIT, some requiring intervention with a diuretic or hospitalization for decompensated heart failure, have been reported [see Adverse Reactions (6.2) ] . (Macitentan label, Warnings and precautions)

  • MagnesiumVitamin and mineralMinor

    Long-term use of loop and thiazide diuretics increases magnesium loss in urine. (NIH Office of Dietary Supplements, Magnesium)

  • MethylprednisolonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Mirabegronbeta-adrenergic agonistMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • MometasonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Nortriptylinetricyclic antidepressantMinor

    The antihypertensive action of guanethidine and similar agents may be blocked. (Nortriptyline label, Warnings)

  • PotassiumVitamin and mineralMinor

    Loop and thiazide diuretics increase potassium loss; supplementation is sometimes prescribed alongside them. (NIH Office of Dietary Supplements, Potassium)

  • PrednisolonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • PrednisonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • TerbinafineantifungalMinor

    Drugs predominantly metabolized by the CYP450 2D6 isozyme include the following drug classes: tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, antiarrhythmics class 1C (e.g., flecainide and propafenone) and monoamine oxidase inhibitors Type B. (Terbinafine label, Drug interactions)

  • TheophyllinemethylxanthineMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • Timololbeta blockerMinor

    Bisoprolol fumarate and hydrochlorothiazide tablets should not be combined with other beta-blocking agents. (Bisoprolol and hydrochlorothiazide label, Drug interactions)

  • TiotropiumanticholinergicMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • TriamcinolonecorticosteroidMinor

    Corticosteroids, ACTH - Intensified electrolyte depletion, particularly hypokalemia. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Vibegronbeta-adrenergic agonistMinor

    A beta 2 agonist (bronchodilator) should be made available. (Bisoprolol and hydrochlorothiazide label, Warnings)

  • ZincVitamin and mineralMinor

    Thiazide diuretics increase zinc loss in urine with long-term use. (NIH Office of Dietary Supplements, Zinc)

No significant interaction reported (2)

  • CimetidineH2 blockerNo interaction

    Pharmacokinetic studies document no clinically relevant interactions with other agents given concomitantly, including thiazide diuretics and cimetidine. (Bisoprolol and hydrochlorothiazide label, Precautions)

  • Ropiniroledopamine agonistNo interaction

    Commonly Administered Drugs: Population analysis showed that commonly administered drugs (e.g., selegiline, amantadine, tricyclic antidepressants, benzodiazepines, ibuprofen, thiazides, antihistamines, anticholinergics) did not affect the clearance of ropinirole. (Ropinirole label, Drug interactions)

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Not medical advice. Severity reflects the label's wording, not your circumstances. A "major" flag can be routine under supervision and a "minor" one can matter at high doses. Ask a pharmacist.