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switch to a hydrophilic statin (rosuvastatin, pravastatin) if myalgias localize SGLT2 inhibitors: reinforce hydration targets (minimum 2.5 L daily) Laxatives or stimulant bowel preps: reduce frequency if already experiencing GLP-1-related diarrhea Tier 3: Low risk but worth documenting ACE inhibitors (can rarely cause cramps through unclear mechanisms) Beta-agonist inhalers (albuterol can lower serum potassium at high doses) The Endocrine Society's 2023 clinical practice guideline on pharmacologic management of obesity recommends monitoring electrolytes during the titration phase of anti-obesity medications, with particular attention to patients on concurrent diuretic therapy 9
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