Can I take Bisoprolol and Empagliflozin together?
Drug interaction guide
Originally published 25 Jan 2026
Meets Patient’s editorial guidelines
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Taking these two medicines together can increase the risk of your blood pressure dropping too low (hypotension) or your blood sugar levels falling too low (hypoglycaemia). Additionally, bisoprolol can sometimes hide the warning signs of low blood sugar, such as a fast heartbeat or tremors.
Why this happens
Both medicines can lower blood pressure: bisoprolol slows the heart rate, while empagliflozin acts as a diuretic (water pill) which reduces fluid in the body. Furthermore, while empagliflozin lowers blood sugar, bisoprolol (a beta-blocker) can interfere with the body's natural response to low sugar and mask symptoms like palpitations.
What you should do
You can usually take these medicines together, but you should monitor your blood pressure and blood sugar levels more closely, especially when starting or changing doses. Be aware that you might not feel the usual 'racing heart' if your sugar drops, so look out for other signs like sweating or hunger. If you feel dizzy, lightheaded, or faint, contact your doctor.
Important precautions
Asthma or chronic obstructive pulmonary disease (COPD)
Bisoprolol can cause your airways to narrow, making it much harder to breathe or triggering a severe asthma attack. It is usually avoided if you have a history of wheezing or asthma.
Diabetes
Bisoprolol can mask the warning signs of low blood sugar (hypoglycaemia), such as a fast heartbeat or tremors. You will need to monitor your blood sugar more closely.
Diabetic ketoacidosis (DKA)
Empagliflozin can cause a serious condition called ketoacidosis even if your blood sugar levels appear normal. You must seek urgent medical help if you develop nausea, vomiting, stomach pain, or fruity-smelling breath.
Fournier's gangrene (necrotising fasciitis of the perineum) - empagliflozin
Seek immediate medical attention if you experience pain, tenderness, redness, or swelling in the genital or anal area, especially if accompanied by fever or a general feeling of being unwell.
Food and drink warnings
Alcohol
Alcohol can increase the blood pressure-lowering effect of bisoprolol, which may make you feel dizzy, lightheaded, or faint, especially when you first start taking it or when your dose is increased. It is best to keep your alcohol intake within recommended limits and see how the medicine affects you before drinking.
Using other medicines
Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.
Disclaimer
This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.
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Article history
The information on this page is written and peer reviewed by qualified clinicians.
Article also available in English, German, Spanish, French, Italian, Portuguese, Hindi, Hebrew, Arabic, and Swedish.
25 Jan 2026 | Originally published
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