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Sotalol Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 5, 2024.

Applies to sotalol: oral solution, oral tablet.

Other dosage forms:

Important warnings This medicine can cause some serious health issues

Oral route (solution)

To minimize the risk of induced arrhythmia, patients initiated or reinitiated on oral sotalol or converted from IV sotalol to oral administration should be placed in a facility that can provide cardiac resuscitation, continuous electrocardiographic monitoring and calculations of creatinine clearance.

Sotalol can cause life threatening ventricular tachycardia associated with QT interval prolongation.

Do not initiate sotalol therapy if the baseline QTc is longer than 450 ms.

If the QT interval prolongs to 500 ms or greater, the dose must be reduced, the interval between doses prolonged, or the drug discontinued.

Adjust the dosing interval based on creatinine clearance.

Oral route (tablet)

To minimize the risk of drug-induced arrhythmia, initiate or reinitiate oral sotalol in a facility that can provide cardiac resuscitation and continuous electrocardiographic monitoring.

Sotalol can cause life threatening ventricular tachycardia associated with QT interval prolongation.

If the QT interval prolongs to 500 msec or greater, reduce the dose, lengthen the dosing interval, or discontinue the drug.

Calculate creatinine clearance to determine appropriate dosing.

Serious side effects of sotalol

Along with its needed effects, sotalol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking sotalol:

More common side effects

  • blurred vision
  • chest pain, tightness, or discomfort
  • confusion
  • difficult or labored breathing
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fast, slow, irregular, pounding, or racing heartbeat or pulse
  • lightheadedness, dizziness, or fainting
  • nausea and vomiting
  • sweating
  • swelling of the face, fingers, feet, or lower legs
  • unusual tiredness or weakness

Less common side effects

  • body aches or pain
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • cough or hoarseness
  • decreased alertness
  • difficulty with speaking
  • dilated neck veins
  • double vision
  • feeling of warmth or heat
  • fever or chills
  • flushing or redness of the skin, especially on the face and neck
  • headache
  • inability to move the arms, legs, or facial muscles
  • inability to speak
  • irregular breathing
  • joint pain or swelling
  • loss of voice
  • lower back or side pain
  • nervousness
  • noisy breathing
  • painful, burning, or difficult urination
  • pounding in the ears
  • slow speech
  • stomach pain or swelling
  • weight gain

Rare side effects

  • fast breathing
  • pinpoint red spots on the skin

Incidence not known

  • black, tarry stools
  • bleeding gums
  • blood in the urine or stools
  • blue lips and fingernails
  • coughing that sometimes produces a pink frothy sputum
  • crying
  • delusions of persecution, mistrust, suspiciousness, or combativeness
  • false or unusual sense of well-being
  • feeling of unreality
  • mental depression
  • not able to move
  • pale skin
  • pinpoint red spots on the skin
  • quick to react or overreact emotionally
  • rapidly changing moods
  • sense of detachment from self or body
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swelling in the legs and ankles
  • swollen glands
  • unusual bleeding or bruising

Get emergency help immediately if any of the following symptoms of overdose occur while taking sotalol:

Symptoms of overdose

Other side effects of sotalol

Some side effects of sotalol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common side effects

  • acid or sour stomach
  • difficulty with sleeping
  • heartburn or indigestion
  • pain in the arms or legs

Less common side effects

  • changes in vision
  • decreased sexual performance or desire
  • loss of appetite
  • mood changes
  • night blindness
  • passing gas
  • skin rash
  • weight changes

Rare side effects

  • feeling of constant movement of self or surroundings
  • hair loss or thinning of the hair
  • itching skin
  • muscle aches, cramps, pains, or stiffness
  • quick to react or overreact emotionally
  • sensation of spinning
  • severe sunburn

Managing side effects (general information)

For healthcare professionals

Applies to sotalol: intravenous solution, oral solution, oral tablet.

Cardiovascular adverse events

Nervous system

Respiratory

Gastrointestinal

Metabolic

Dermatologic

Musculoskeletal

Genitourinary

Hematologic

Immunologic

Local

Ocular

Other

Psychiatric

References

1. Gossinger HD, Siostrzonek P, Schmoliner R, Grimm G, Jager U, Mosslacher H (1987) "Sotalol-induced torsades de pointes in a patient with pre-existent normal response to programmed ventricular stimulation." Eur Heart J, 8, p. 1351-3

2. (2001) "Product Information. Betapace (sotalol)." Berlex Laboratories

3. Hohnloser SH, Vandeloo A, Baedeker F (1995) "Efficacy and proarrhythmic hazards of pharmacologic cardioversion of atrial fibrillation: prospective comparison of sotalol versus quinidine." J Am Coll Cardiol, 26, p. 852-8

4. British Medical Association. Royal Pharmaceutical Society of Great Britain. Joint Formulary Committee (2006) British National Formulary. http://bnf.org/bnf/

5. Pharmaceutical Society of Australia (2006) APPGuide online. Australian prescription products guide online. http://www.appco.com.au/appguide/default.asp

6. Lehtonen A, Hietanen E, Marniemi J, Peltonen P, Nikkila EA (1983) "Effect of sotalol withdrawal on serum lipids and lipoprotein lipase activity." Int J Clin Pharmacol Ther Toxicol, 21, p. 73-6

Frequently asked questions

Further information

Sotalol side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer