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Bisoprolol / hydrochlorothiazide Pregnancy and Breastfeeding Warnings

Medically reviewed by Last updated on Mar 30, 2021.

Bisoprolol / hydrochlorothiazide is also known as: Ziac

Bisoprolol / hydrochlorothiazide Pregnancy Warnings

Animal models have revealed fetotoxicity at doses that produced maternal toxicity. Animal studies with bisoprolol have revealed evidence of embryolethality. There are no controlled data in human pregnancy.

US FDA pregnancy category C: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Use is recommended only if clearly needed and the benefit outweighs the risk to the fetus.

US FDA pregnancy category: C

See references

Bisoprolol / hydrochlorothiazide Breastfeeding Warnings

A decision should be made to discontinue breastfeeding or discontinue the drug, taking into account the importance of the drug to the mother.

Excreted into human milk: Unknown (bisoprolol); Yes (hydrochlorothiazide)
Excreted into animal milk: Yes (bisoprolol)

Bisoprolol: This drug is expected to have a moderately high risk of accumulation in nursing infants due to 30% protein binding, 50% renal excretion, and a moderately long half-life. Beta blockers with similar excretion profiles have caused adverse events in breastfed newborns.
Hydrochlorothiazide: This drug was shown to be without apparent harmful effects at 50 mg or less per day.

See references

References for pregnancy information

  1. "Product Information. Ziac (bisoprolol-hydrochlorothiazide)." Lederle Laboratories (2001):

References for breastfeeding information

  1. "Product Information. Ziac (bisoprolol-hydrochlorothiazide)." Lederle Laboratories (2001):
  2. United States National Library of Medicine "Toxnet. Toxicology Data Network." (2013):

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.