Ziac Use In Pregnancy & Lactation

Pregnancy: Bisoprolol has pharmacological effects that may cause harmful effects on pregnancy and/or the fetus/newborn.
In general, beta-adrenoceptor blockers reduce placental perfusion, which has been associated with growth retardation, intrauterine death, abortion or early labor. Adverse effects (e.g. hypoglycemia and bradycardia) may occur in the fetus and newborn infant. If treatment with beta-adrenoceptor blockers is necessary, beta₁-selective adrenoceptor blockers are preferable.
Diuretics may give rise to fetoplacental ischemia with the attendant risk of fetal hypotrophy.
Hydrochlorothiazide is suspected to cause thrombocytopenia in the neonate.
Bisoprolol + hydrochlorothiazide (Ziac) is not recommended during pregnancy.
Lactation: Bisoprolol + hydrochlorothiazide (Ziac) is not recommended in breastfeeding women because bisoprolol may be, and hydrochlorothiazide is excreted in breast milk in minimal amounts. Hydrochlorothiazide can inhibit the milk production.
Fertility: No human data on fertility are known for the combination product. Bisoprolol or hydrochlorothiazide had no influence on fertility or on general reproduction performance in animal studies.