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Sorine (sotalol) Disease Interactions

There are 20 disease interactions with Sorine (sotalol):

Major

Beta-Blockers (Includes Sorine) ↔ Asthma/Copd

Severe Potential Hazard, High plausibility

Applies to: Chronic Obstructive Pulmonary Disease, Asthma

Some beta-adrenergic receptor blocking agents (i.e., beta-blockers) are contraindicated in patients with bronchial asthma or with a history of bronchial asthma, or severe chronic obstructive pulmonary disease. In general, beta-adrenergic receptor blocking agents should not be used in patients with bronchospastic diseases. Beta blockade may adversely affect pulmonary function by counteracting the bronchodilation produced by catecholamine stimulation of beta-2 receptors. If beta-blocker therapy is necessary in these patients, an agent with beta-1 selectivity (e.g., atenolol, metoprolol, betaxolol) is considered safer, but should be used with caution nonetheless. Cardioselectivity is not absolute and can be lost with larger doses.

References

  1. Horvath JS, Woolcock AJ, Tiller DJ, Donnelly P, Armstrong J, Caterson R "A comparison of metoprolol and propranolol on blood pressure and respiratory function in patients with hypertension." Aust N Z J Med 8 (1978): 1-6
  2. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
  3. Falliers CJ, Vincent ME, Medakovic M "Effect of single doses of labetalol, metoprolol, and placebo on ventilatory function in patients with bronchial asthma: interaction with isoproterenol." J Asthma 23 (1986): 251-60
View all 29 references
Major

Beta-Blockers (Includes Sorine) ↔ Bradyarrhythmia/Av Block

Severe Potential Hazard, High plausibility

Applies to: Heart Block, Sinus Node Dysfunction

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with sinus bradyarrhythmia or heart block greater than the first degree (unless a functioning pacemaker is present). Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to exacerbate these conditions.

References

  1. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Trandate (labetalol)." Glaxo Wellcome, Research Triangle Park, NC.
View all 21 references
Major

Beta-Blockers (Includes Sorine) ↔ Cardiogenic Shock/Hypotension

Severe Potential Hazard, High plausibility

Applies to: Cardiogenic Shock, Hypotension

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) is contraindicated in patients with hypotension or cardiogenic shock. Due to their negative inotropic and chronotropic effects on the heart, the use of beta-blockers is likely to further depress cardiac output and blood pressure, which can be detrimental in these patients.

References

  1. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  2. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  3. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
View all 23 references
Major

Beta-Blockers (Includes Sorine) ↔ Diabetes

Severe Potential Hazard, High plausibility

Applies to: Diabetes Mellitus

Beta-adrenergic receptor blocking agents (aka beta-blockers) may mask symptoms of hypoglycemia such as tremors, tachycardia and blood pressure changes. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may inhibit catecholamine-mediated glycogenolysis, thereby potentiating insulin-induced hypoglycemia and delaying the recovery of normal blood glucose levels. Since cardioselectivity is not absolute, larger doses of beta-1 selective agents may demonstrate these effects as well. Therapy with beta-blockers should be administered cautiously in patients with diabetes or predisposed to spontaneous hypoglycemia.

References

  1. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  2. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  3. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
View all 21 references
Major

Beta-Blockers (Includes Sorine) ↔ Hypersensitivity

Severe Potential Hazard, High plausibility

Applies to: Allergies

The use of beta-adrenergic receptor blocking agents (aka beta-blockers) in patients with a history of allergic reactions or anaphylaxis may be associated with heightened reactivity to culprit allergens. The frequency and/or severity of attacks may be increased during beta-blocker therapy. In addition, these patients may be refractory to the usual doses of epinephrine used to treat acute hypersensitivity reactions and may require a beta-agonist such as isoproterenol.

References

  1. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
  2. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
View all 16 references
Major

Beta-Blockers (Includes Sorine) ↔ Pvd

Severe Potential Hazard, High plausibility

Applies to: Peripheral Arterial Disease

Due to their negative inotropic and chronotropic effects on the heart, beta-adrenergic receptor blocking agents (aka beta-blockers) reduce cardiac output and may precipitate or aggravate symptoms of arterial insufficiency in patients with peripheral vascular disease. In addition, the nonselective beta-blockers (e.g., propranolol, pindolol, timolol) may attenuate catecholamine-mediated vasodilation during exercise by blocking beta-2 receptors in peripheral vessels. Therapy with beta-blockers should be administered cautiously in patients with peripheral vascular disease. Close monitoring for progression of arterial obstruction is advised.

References

  1. "Product Information. Cartrol (carteolol)." Abbott Pharmaceutical, Abbott Park, IL.
  2. Coppeto JR "Transient ischemic attacks and amaurosis fugax from timolol." Ann Ophthalmol 17 (1985): 64-5
  3. "Product Information. Inderal (propranolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
View all 25 references
Major

Sotalol (Includes Sorine) ↔ Hemodialysis

Severe Potential Hazard, High plausibility

Applies to: hemodialysis

Therapy with sotalol should be administered cautiously in patients with renal failure undergoing hemodialysis. The half-life of sotalol is prolonged (up to 69 hours) in anuric patients. Although sotalol is partially removed by hemodialysis, a rebound in drug concentration often occurs after dialysis is complete. Sotalol should preferably be administered after dialysis and after hemodynamic stability has been established. Heart rate and ECG, particularly the QTc interval, must be closely monitored.

References

  1. Tjandramaga TB, Verbeeck R, Thomas J, Verbesselt R, Verberckmoes R, Schepper PJD "The effect of end-stage renal failure and haemodialysis on the elimination kinetics of sotalol." Br J Clin Pharmacol 3 (1976): 259-65
  2. Tjandramaga TB, Verbeeck R, Verbesselt R, Verberckmoes R, De Schepper PJ. Influence of chronic renal failure and haemodialysis on the elimination of the beta-adrenoceptor blocking drugs practolol and sotalol. In: Saxena PR, Forsyth R P, eds. "Beta-adrenoceptor Blocking Agents." Amsterdam, North-Holland, : (1976): 323-33
  3. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
View all 4 references
Major

Sotalol (Includes Sorine) ↔ Qt Interval Prolongation

Severe Potential Hazard, High plausibility

Applies to: Hypokalemia, Diarrhea, Magnesium Imbalance, Electrolyte Abnormalities, Abnormal Electrocardiogram, Long QT Syndrome, Arrhythmias

The use of sotalol is contraindicated in patients with congenital or acquired QT interval prolongation syndromes. Sotalol has dose-dependent proarrhythmic effects related to prolongation of the QT interval. The risk of torsades de pointes is progressively increased as the degree of prolongation becomes greater. The manufacturer states that sotalol should be used with particular caution in patients whose QTc is greater than 500 msec on-therapy. Serious consideration should be given to reducing the dosage or discontinuing therapy when the QTc exceeds 550 msec.

The use of sotalol is contraindicated in patients with hypokalemia (< 4 meq/L). Electrolyte disturbances such as hypokalemia and hypomagnesemia may augment the prolongation effect of sotalol on the QT interval and should be corrected prior to institution of sotalol therapy. In addition, patients who experience frequent, severe, or prolonged diarrhea may be subject to electrolyte losses and should be followed closely and managed accordingly during therapy with sotalol.

References

  1. Gossinger HD, Siostrzonek P, Schmoliner R, Grimm G, Jager U, Mosslacher H "Sotalol-induced torsades de pointes in a patient with pre-existent normal response to programmed ventricular stimulation." Eur Heart J 8 (1987): 1351-3
  2. Arstall MA, Hii JT, Lehman RG, Horowitz JD "Sotalol-induced torsade de pointes: management with magnesium infusion." Postgrad Med J 68 (1992): 289-90
  3. Allberry RA "Torsade de pointes." Anaesthesia 38 (1983): 910
View all 18 references
Major

Sotalol (Includes Sorine) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Sotalol is primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from sotalol, including torsade de pointes and worsened ventricular tachycardia, due to decreased drug clearance. Therapy with sotalol should be administered cautiously in patients with renal impairment. Dosage adjustments (i.e. prolongation of dosing interval) are recommended in patients with moderate to severe renal dysfunction (CrCl <= 60 mL/min), and dosage escalations should occur not more often than after administration of every 5 to 6 doses. Heart rate and ECG, particularly the QTc interval, should be closely monitored.

References

  1. Blair AD, Burgess ED, Maxwell BM, Cutler RE "Sotalol kinetics in renal insufficiency." Clin Pharmacol Ther 29 (1981): 457-63
  2. Berglund G, Descamps R, Thomis JA "Pharmacokinetics of sotalol after chronic administration to patients with renal insufficiency." Eur J Clin Pharmacol 18 (1980): 321-6
  3. Tjandramaga TB, Verbeeck R, Verbesselt R, Verberckmoes R, De Schepper PJ. Influence of chronic renal failure and haemodialysis on the elimination of the beta-adrenoceptor blocking drugs practolol and sotalol. In: Saxena PR, Forsyth R P, eds. "Beta-adrenoceptor Blocking Agents." Amsterdam, North-Holland, : (1976): 323-33
View all 7 references
Moderate

Beta-Blockers (Includes Sorine) ↔ Cerebrovascular Insufficiency

Moderate Potential Hazard, Moderate plausibility

Applies to: Cerebrovascular Insufficiency

Beta-adrenergic blocking agents (beta-blockers), should be used with caution in patients with cerebrovascular insufficiency because of their potential effects relative to blood pressure and pulse. If signs or symptoms suggesting reduced cerebral blood flow are observed, consideration should be given to discontinuing these agents.

Moderate

Beta-Blockers (Includes Sorine) ↔ Chf

Moderate Potential Hazard, High plausibility

Applies to: Congestive Heart Failure

Beta-adrenergic receptor blocking agents (aka beta-blockers) in general should not be used in patients with overt congestive heart failure (CHF). Sympathetic stimulation may be important in maintaining the hemodynamic function in these patients, thus beta-blockade can worsen the heart failure. However, therapy with beta-blockers may be beneficial and can be administered cautiously in some CHF patients provided they are well compensated and receiving digitalis, diuretics, an ACE inhibitor, and/or nitrates. Carvedilol, specifically, is indicated for use with these agents in the treatment of mild to severe heart failure of ischemic or cardiomyopathic origin. There is also increasing evidence that the addition of a beta-blocker to standard therapy can improve morbidity and mortality in patients with advanced heart failure, although it is uncertain whether effectiveness varies significantly with the different agents. Data from one meta-analysis study suggest a greater reduction of mortality risk for nonselective beta-blockers than for beta-1 selective agents.

References

  1. "Product Information. Corgard (nadolol)." Bristol-Myers Squibb, Princeton, NJ.
  2. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  3. Tcherdakoff P "Side-effects with long-term labetalol: an open study of 251 patients in a single centre." Pharmatherapeutica 3 (1983): 342-8
View all 47 references
Moderate

Beta-Blockers (Includes Sorine) ↔ Glaucoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Glaucoma/Intraocular Hypertension

Systemic beta-adrenergic receptor blocking agents (aka beta-blockers) may lower intraocular pressure. Therefore, patients with glaucoma or intraocular hypertension may require adjustments in their ophthalmic regimen following a dosing change or discontinuation of beta-blocker therapy.

References

  1. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
  2. "Product Information. Sectral (acebutolol)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  3. "Product Information. Zebeta (bisoprolol)." Lederle Laboratories, Wayne, NJ.
View all 15 references
Moderate

Beta-Blockers (Includes Sorine) ↔ Hyperlipidemia

Moderate Potential Hazard, Low plausibility

Applies to: Hyperlipidemia

Beta-adrenergic receptor blocking agents (aka beta-blockers) may alter serum lipid profiles. Increases in serum VLDL and LDL cholesterol and triglycerides, as well as decreases in HDL cholesterol, have been reported with some beta-blockers. Patients with preexisting hyperlipidemia may require closer monitoring during beta-blocker therapy, and adjustments made accordingly in their lipid-lowering regimen.

References

  1. Samuel P, Chin B, Schoenfeld BH, et al "Comparison of the effect of pindolol versus propranolol on the lipid profile in patients treated for hypertension." Br J Clin Pharmacol 24 (1987): s63-4
  2. Gordon NF, Scott CB, Duncan JJ "Effects of atenolol versus enalapril on cardiovascular fitness and serum lipids in physically active hypertensive men." Am J Cardiol 79 (1997): 1065-9
  3. Lithell H, Andersson PE "Metabolic effects of carvedilol in hypertensive patients." Eur J Clin Pharmacol 52 (1997): 13-7
View all 39 references
Moderate

Beta-Blockers (Includes Sorine) ↔ Hyperthyroidism

Moderate Potential Hazard, High plausibility

Applies to: Hyperthyroidism

When beta-adrenergic receptor blocking agents (aka beta-blockers) are used to alleviate symptoms of hyperthyroidism such as tachycardia, anxiety, tremor and heat intolerance, abrupt withdrawal can exacerbate thyrotoxicosis or precipitate a thyroid storm. To minimize this risk, cessation of beta-blocker therapy, when necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks. Patients should be advised not to discontinue treatment without first consulting with the physician. Close monitoring is recommended during and after therapy withdrawal.

References

  1. "Product Information. Kerlone (betaxolol)." Searle, Skokie, IL.
  2. "Product Information. Lopressor (metoprolol)." Novartis Pharmaceuticals, East Hanover, NJ.
  3. "Product Information. Coreg (carvedilol)." SmithKline Beecham, Philadelphia, PA.
View all 15 references
Moderate

Beta-Blockers (Includes Sorine) ↔ Ischemic Heart Disease

Moderate Potential Hazard, High plausibility

Applies to: Ischemic Heart Disease

Heightened sensitivity to catecholamines may occur after prolonged use of beta-adrenergic receptor blocking agents (aka beta-blockers). Exacerbation of angina, myocardial infarction and ventricular arrhythmias have been reported in patients with coronary artery disease following abrupt withdrawal of therapy. Cessation of beta-blocker therapy, whenever necessary, should occur gradually with incrementally reduced dosages over a period of 1 to 2 weeks in patients with coronary insufficiency. Patients should be advised not to discontinue treatment without first consulting with the physician. In patients who experience an exacerbation of angina following discontinuation of beta-blocker therapy, the medication should generally be reinstituted, at least temporarily, along with other clinically appropriate measures.

References

  1. "Product Information. Betapace (sotalol)." Berlex, Richmond, CA.
  2. "Product Information. Levatol (penbutolol)." Reed and Carnrick, Jersey City, NJ.
  3. "Product Information. Visken (pindolol)." Sandoz Pharmaceuticals Corporation, East Hanover, NJ.
View all 19 references
Moderate

Beta-Blockers (Includes Sorine) ↔ Myasthenia Gravis

Moderate Potential Hazard, Low plausibility

Applies to: Myoneural Disorder

Beta-adrenergic receptor blocking agents (aka beta-blockers) may potentiate muscle weakness consistent with certain myasthenic symptoms such as diplopia, ptosis, and generalized weakness. Several beta-blockers have been associated rarely with aggravation of muscle weakness in patients with preexisting myasthenia gravis or myasthenic symptoms.

References

  1. Coppeto JR "Timolol-associated myasthenia gravis." Am J Ophthalmol 98 (1984): 244-5
  2. Herishanu Y, Rosenberg P "Beta-blockers and myasthenia gravis." Ann Intern Med 83 (1975): 834-5
  3. "Product Information. Blocadren (timolol)." Merck & Co, Inc, West Point, PA.
View all 7 references
Moderate

Beta-Blockers (Includes Sorine) ↔ Pheochromocytoma

Moderate Potential Hazard, Moderate plausibility

Applies to: Pheochromocytoma

Administration of beta-blockers alone in the setting of pheochromocytoma has been associated with a paradoxical increase in blood pressure due to the attenuation of beta-mediated vasodilatation in skeletal muscle. In patients with pheochromocytoma, an alph-blocking agent should be initiated prior to the use of any beta-blocking agent. Caution should be taken in the administration of these agents to patients suspected of having pheochromocytoma.

Moderate

Beta-Blockers (Includes Sorine) ↔ Psoriasis

Moderate Potential Hazard, Moderate plausibility

Applies to: Psoriasis

The use of beta-blockers in psoriatic patients should be carefully weighed since the use of these agents may cause an aggravation in psoriasis.

Moderate

Beta-Blockers (Includes Sorine) ↔ Tachycardia

Moderate Potential Hazard, Moderate plausibility

Applies to: Tachyarrhythmia

Beta-adrenergic blockade in patients with Wolff-Parkinson-White syndrome and tachycardia has been associated with severe bradycardia requiring treatment with a pacemaker. In one case, this result was reported after an initial dose of 5 mg propranolol. The use of beta-adrenergic receptor blocking agents (aka beta-blockers) should be administered cautiously in these patients.

Moderate

Non-Selective Beta-Blockers (Includes Sorine) ↔ Prinzmetal's Variant Angina

Moderate Potential Hazard, Moderate plausibility

Applies to: Prinzmetal's Angina

Agents with non-selective beta-blocking activity may provoke chest pain in patients with Prinzmetal's variant angina. the use of non-selective beta blockers is not recommended in these patients. Caution should be taken in the administration of these agents to patients suspected of having Prinzmetal's variant angina.

Sorine (sotalol) drug Interactions

There are 963 drug interactions with Sorine (sotalol)

Sorine (sotalol) alcohol/food Interactions

There are 3 alcohol/food interactions with Sorine (sotalol)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

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