Questions about Atrial Fibrillation? Get answers from our expert.

Generic Name: sotalol (SOE-ta-lol)
Brand Name: Betapace AF

Because sotalol may sometimes cause an abnormal or irregular heartbeat, patients who begin taking or restart sotalol should be observed in a hospital or similar setting in which heart and kidney function monitoring may be performed for at least 3 days after starting sotalol. Close monitoring of your heart or kidney function may also be needed if your dose is changed. Do not change from one brand or generic version of sotalol to another without consulting your doctor or pharmacist. Sotalol is labeled specifically for atrial fibrillation or atrial flutter.


Sotalol is used for:

Maintaining a normal heartbeat rhythm in patients who have atrial fibrillation or atrial flutter (a type of abnormal heartbeat rhythm).

Sotalol is an antiarrhythmic medicine. It works by helping the heart beat regularly for a longer period of time.

Do NOT use sotalol if:

  • you are allergic to any ingredient in sotalol
  • you have certain types of irregular heartbeat (eg, long QT syndrome, prolonged QT interval), shock caused by serious heart problems, uncontrolled heart failure, low blood potassium or magnesium levels, certain lung or breathing problems (eg, asthma, bronchitis, emphysema), severe kidney problems, or you are on dialysis
  • you have a very slow heartbeat or certain types of irregular heartbeat (sick sinus syndrome, second- or third-degree heart block) and you do not have a permanent pacemaker
  • you are taking certain antiarrhythmics (eg, amiodarone, disopyramide, dofetilide, procainamide, quinidine), bepridil, cisapride, mibefradil, nilotinib, tetrabenazine, a theophylline (eg, aminophylline), a tricyclic antidepressant (eg, amitriptyline), or vardenafil

Contact your doctor or health care provider right away if any of these apply to you.

Before using sotalol:

Some medical conditions may interact with sotalol. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have breathing or lung problems (eg, chronic obstructive pulmonary disorder [COPD], asthma); an overactive thyroid; kidney problems; diabetes; blood flow problems; a tumor on your adrenal gland; loss of appetite; increased thirst; or severe or persistent diarrhea, sweating, or vomiting
  • if you have a history of other heart problems (eg, heart failure, slow or irregular heartbeat, a recent heart attack), blood electrolyte problems (eg, low blood potassium or magnesium levels), problems with the acid or base levels in your body, or episodes of low blood sugar
  • if you are scheduled for surgery

Some MEDICINES MAY INTERACT with sotalol. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Indomethacin because it may decrease sotalol's effectiveness
  • Calcium channel blockers (eg, diltiazem, verapamil), clonidine, digoxin, diuretics (eg, furosemide, hydrochlorothiazide), guanethidine, mibefradil, or reserpine because the risk of side effects, such as low blood pressure or heart problems, may be increased
  • Antiarrhythmics (eg, dronedarone, propafenone), arsenic, astemizole, bepridil , chloroquine, cisapride, dolasetron, domperidone, droperidol, fingolimod, fluconazole, halofantrine, haloperidol, iloperidone, ketanserin, macrolides and ketolides (eg, erythromycin), maprotiline, mefloquine, methadone, nilotinib, oseltamivir, paliperidone, pentamidine, phenothiazines (eg, chlorpromazine, thioridazine), pimozide, quinolones (eg, ciprofloxacin), romidepsin, saquinavir, terfenadine, tetrabenazine, tricyclic antidepressants (eg, amitriptyline), tyrosine kinase inhibitors (eg, dasatinib), vardenafil, or ziprasidone because the risk of abnormal heart rhythms may be increased
  • Epinephrine, insulin, lidocaine, meglitinide antidiabetics (eg, nateglinide), or quinazolines (eg, prazosin) because the risk of their side effects may be increased by sotalol
  • Beta-agonists (eg, albuterol) or theophyllines (eg, aminophylline) because their effectiveness may be decreased by sotalol

This may not be a complete list of all interactions that may occur. Ask your health care provider if sotalol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use sotalol:

Use sotalol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • An extra patient leaflet is available with sotalol. Talk to your pharmacist if you have questions about this information.
  • Take sotalol by mouth with or without food. Try to take it the same way (either with food or without food) each time you take your dose. Check with your doctor or pharmacist if you have questions about taking sotalol with food.
  • Do not take an antacid that has aluminum or magnesium in it within 2 hours before or after you take sotalol.
  • Sotalol works best if it is taken at the same time each day. Taking sotalol at the same time each day will also help you remember to take it.
  • Continue to use sotalol even if you feel well. Do not miss any doses.
  • If you miss a dose of sotalol, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use sotalol.

Important safety information:

  • Sotalol may cause dizziness or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use sotalol with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Sotalol may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Do NOT take more than the recommended dose or change your dose without checking with your doctor.
  • Tell your doctor or dentist that you take sotalol before you receive any medical or dental care, emergency care, or surgery.
  • Do not suddenly stop taking sotalol. Sharp chest pain, irregular heartbeat, and, sometimes, heart attack may occur if you suddenly stop sotalol. The risk may be greater if you have certain types of heart disease. Heart disease is common and you may not know you have it. Your doctor should slowly lower your dose over several weeks if you need to stop taking it. Limit physical activity while you are lowering your dose. If new or worsened chest pain or other heart problems occur, contact your doctor right away. You may need to start taking sotalol again.
  • Diabetes patients - Sotalol may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • Diabetes patients - Sotalol may hide signs of low blood sugar, such as rapid heartbeat. Be sure to watch for other signs of low blood sugar. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your vision change; give you a headache, chills, or tremors; or make you more hungry. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.
  • If you have a history of any severe allergic reaction, talk with your doctor. You may be at risk of an even more severe allergic reaction if you come into contact with the substance that caused your allergy. Some medicines used to treat severe allergies may also not work as well while you are taking sotalol.
  • Sotalol may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking sotalol.
  • Lab tests, including kidney and heart function, and blood pressure monitoring, may be performed while you take sotalol. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking sotalol while you are pregnant. Sotalol is found in breast milk. Do not breast-feed while taking sotalol.

Possible side effects of sotalol:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; headache; lightheadedness; mild diarrhea, nausea, or stomach pain; tiredness; trouble sleeping.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); abnormally fast, slow, or irregular heartbeat; changes in vision; chest pain; decreased appetite; excessive thirst; fainting; numbness of an arm or leg; severe or persistent nausea, vomiting, or diarrhea; severe or persistent tiredness; severe stomach pain; shortness of breath; sudden leg pain; sudden, severe headache, vomiting, or dizziness; unusual sweating.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include difficulty breathing; dizziness; fainting; fatigue; severe weakness; slow heartbeat.

Proper storage of sotalol:

Store sotalol at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep sotalol out of the reach of children and away from pets.

General information:

  • If you have any questions about sotalol, please talk with your doctor, pharmacist, or other health care provider.
  • Sotalol is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take sotalol or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about sotalol. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to sotalol. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using sotalol.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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