Indications
Sotalol Hydrochloride is used to treat and prevent certain serious abnormal heart rhythms (arrhythmias). These include life-threatening fast rhythms from the lower chambers of the heart (ventricular arrhythmias) and, in selected patients, to keep a normal rhythm after atrial fibrillation or atrial flutter has been corrected.
How It Works
Sotalol works in two ways. It is a beta blocker, so it slows the heart rate and reduces the effect of adrenaline on the heart. It also lengthens the recovery period of heart muscle cells between beats (a class III antiarrhythmic effect), which makes it harder for abnormal rhythms to start and continue.
Dosage and Administration
Sotalol is started by a heart specialist, often in hospital with continuous ECG (heart tracing) monitoring for the first few days, because it can cause a dangerous rhythm in some people. The dose is as prescribed and depends on kidney function and the ECG; it is increased slowly. Tablets are usually taken twice a day, ideally at the same times each day and on an empty stomach, about 1 to 2 hours before meals. Do not stop suddenly, as this can worsen chest pain or rhythm problems; your doctor will reduce the dose gradually if needed.
Interactions
- Other medicines that affect heart rhythm (prolong the QT interval), such as Amiodarone, Quinidine, some antibiotics (Erythromycin, Moxifloxacin), some antipsychotics and antidepressants: risk of dangerous rhythms.
- Diuretics that lower potassium or magnesium: increase rhythm risk.
- Calcium channel blockers such as Verapamil and Diltiazem, Digoxin and other beta blockers: may cause very slow heart rate and low blood pressure.
- Antacids containing aluminium or magnesium: take at least 2 hours apart from Sotalol.
- Insulin and diabetes tablets: Sotalol may hide signs of low blood sugar.
Contraindications
Do not take Sotalol if you have asthma or severe lung disease with wheezing, a very slow heart rate, certain heart blocks or sick sinus syndrome without a pacemaker, uncontrolled heart failure, cardiogenic shock, a long QT interval, low potassium, severe kidney failure, or an allergy to it.
Side Effects
Common side effects include tiredness, slow heartbeat, dizziness, shortness of breath, cold hands and feet, headache, nausea, sleep problems and reduced sexual ability.
Get urgent medical help if you have fainting or near fainting, a very fast, irregular or pounding heartbeat, chest pain, severe breathlessness or wheezing, swelling of the ankles with rapid weight gain, or severe diarrhoea or vomiting (which can lower potassium and increase rhythm risk).
Pregnancy and Lactation
Sotalol crosses the placenta and may slow the baby’s heart rate or growth; it is used in pregnancy only if the doctor feels it is needed, with monitoring. It passes into breast milk in large amounts, so breastfeeding is usually not recommended or should only be done with close monitoring of the baby, as advised by your doctor.
Precautions and Warnings
Regular ECGs and blood tests for kidney function, potassium and magnesium are needed. Tell any doctor treating you that you take Sotalol, especially before surgery. Use with care in diabetes, thyroid disease, psoriasis and peripheral circulation problems. Avoid getting dehydrated.
Overdose
An overdose can cause a very slow heart rate, low blood pressure, wheezing, low blood sugar, dangerous rhythms and collapse. Get emergency medical help straight away.
Therapeutic Class
Antiarrhythmic, beta blocker with class III activity.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.