Moderate
Amlodipine × Empagliflozin
Calcium channel blockers (dihydropyridines)×Sodium-glucose co-transporter 2 inhibitors (SGLT2i)
Mechanism
SGLT2 inhibitors (empagliflozin) cause osmotic diuresis and mild hypovolaemia. Combined with amlodipine: risk of hypotension and acute kidney injury in dehydration.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk.
Management
Standard combination in type 2 diabetes with hypertension. In hypovolaemia (dehydration, vomiting, diarrhoea), temporarily stop empagliflozin. Check blood pressure and creatinine 2 weeks after start.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Sources
- ESC: ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (2021)– McDonagh TA et al. Eur Heart J 2021;42:3599-3726