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The following interactions are largely theoretical or based on case reports, but warrant clinical caution: Insulin and oral hypoglycaemic agents (e.g., sulfonylureas) there is a theoretical risk of enhanced blood glucose-lowering effects, potentially contributing to hypoglycaemia Diuretics concurrent use may exacerbate potassium depletion (hypokalaemia) Digoxin low potassium levels can increase the risk of digoxin toxicity Long-term or high-dose consumption of acetic acid has been associated with reduced bone mineral density and low potassium levels in published case reports, though evidence from pill-based supplementation specifically is sparse

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