ModerateSelective beta-adrenergic blockers×Sodium-glucose co-transporter 2 inhibitors (SGLT2i)
Updated · Methodology
Mechanism
Empagliflozin (SGLT2 inhibitor) causes osmotic diuresis and mild hypovolaemia. Combined with a beta-blocker: additive orthostatic hypotension risk, especially in the first weeks.
Symptoms
Lower blood pressure, postural dizziness, fatigue. Older patients: fall risk. With additional antihypertensives: bradycardia (pulse below 60/min).
Management
The combination is part of guideline-directed therapy in heart failure with reduced ejection fraction and type 2 diabetes. 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.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
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
- AEMPS: Ficha técnica: Bisoprolol (nº registro 78903), sección 4.5 (2026)– AEMPS, CIMA, nº registro 78903, revisión 05/2026, sección 4.5