Minor
Established
Deskripsi
Empagliflozin and losartan can both reduce blood pressure and lower serum potassium/sodium; combined use may increase the risk of dehydration, hypotension, and electrolyte imbalance.
Mekanisme
Empagliflozin causes osmotic diuresis via SGLT2 inhibition; losartan reduces aldosterone-mediated sodium retention and promotes potassium retention; combined volume loss and haemodynamic effects are additive.
Signifikansi Klinis
Clinical trials show that combining SGLT2 inhibitors with renin-angiotensin system blockers reduces cardiovascular events; acute kidney injury from volume depletion is a recognised risk.
Penatalaksanaan
Ensure adequate hydration; monitor renal function and electrolytes; counsel patients to hold empagliflozin during acute illness or surgery (sick-day guidance).