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Sotalol

Pronunciation: so-TAH-loll
Generic name: sotalol
Brand names: Betapace, Betapace AF, Sorine, Sotalol Hydrochloride AF, Sotylize
Dosage form: intravenous solution (15 mg/mL), oral solution (5 mg/mL), oral tablet (120 mg; 160 mg; 240 mg; 80 mg; AF 120 mg; AF 160 mg; AF 80 mg)
Drug classes: Group III antiarrhythmics, Non-cardioselective beta blockers

Medically reviewed by Carmen Pope, BPharm. Last updated on Oct 18, 2023.

What is sotalol?

Sotalol is a beta-blocker with antiarrhythmic properties that affects the heart and circulation within the atrium and ventricles (the upper and lower chambers of the heart that allow blood to flow into and out of the heart).

Sotalol may be used to help keep the heart beating normally in people with certain documented heart rhythm disorders, such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. Sotalol may also be used for other purposes.

Sotalol was first FDA-approved on October 30, 1992.

Warnings

You should not use sotalol if you have asthma, low potassium, or a serious heart condition such as severe heart failure, long QT syndrome, slow heartbeats that have caused you to faint, "sick sinus syndrome" or "AV block" (unless you have a pacemaker).

Monitoring in a facility that can provide cardiac resuscitation, continuous electrocardiographic monitoring, and calculations of creatinine clearance for a minimum of 3 days is recommended for patients initiating or reinitiating sotalol to minimize the risk of induced arrhythmia.

May cause life-threatening ventricular tachycardia associated with QT interval prolongation.

IV sotalol treatment should not be initiated if the baseline QTc is longer than 450ms. Reduce the dosage or discontinue if the interval extends to 500 ms or greater.

Do not substitute one brand of sotalol for another without your doctor’s advice because of potentially significant differences in labeling, dosing and administration, and safety information.

Before taking sotalol

You should not use sotalol if you are allergic to it, or any of the inactive ingredients in the tablets, or if you have:

Do not give sotalol to a child without medical advice.

Tell your doctor if you have ever had:

Tell your doctor about all the medications you take. Any with antiarrhythmic properties may need to be discontinued before starting sotalol.

Tell your doctor if you are pregnant. Sotalol can cross the placenta and affect the unborn baby, causing problems such as growth restriction, transient slow heartbeat in the fetus, laboratory changes, QT prolongation, uterine contractions, and other adverse effects. Talk with your doctor about using sotalol before you get pregnant. If you inadvertently become pregnant while taking sotalol, or are currently pregnant, discuss the risks vs benefits of using sotalol with your doctor.

You should not breastfeed while using sotalol.

How should I take sotalol?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Call your doctor if you are sick with vomiting or diarrhea, or if you have increased thirst, decreased appetite, or are sweating more than usual. You can easily become dehydrated while taking sotalol. This can lead to very low blood pressure, a serious electrolyte imbalance, or kidney failure.

You will need frequent medical tests. Your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG). You may also need heart function tests for 1 to 2 weeks after your last dose.

Keep using this medicine as directed, even if you feel well. You may need to take sotalol for the rest of your life.

Do not skip doses or stop using sotalol without your doctor's advice. Stopping suddenly may make your condition worse. Follow your doctor's instructions about tapering your dose.

If you need surgery, tell your surgeon you currently use this medicine.

There is an intravenous formulation of sotalol which may be substituted for oral sotalol after a dosage adjustment in people unable to take oral medications or for faster achievement of steady-state levels. A healthcare provider will give you this injection as an infusion into your vein.

diltiazem, Xarelto, digoxin, rivaroxaban, flecainide, sotalol, magnesium sulfate, propafenone, Multaq, acebutolol

What happens if I miss a dose?

Skip the missed dose and use your next dose at the regular time. Do not double the dose or shorten the dosing interval.

Try not to miss any doses. Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of sotalol can be fatal.

What are the side effects of sotalol?

Get emergency medical help if you have signs of an allergic reaction such as hives; difficulty breathing; or swelling of your face, lips, tongue, or throat.

Sotalol may cause serious side effects. Call your doctor at once if you have:

Common side effects of sotalol may include:

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

What should I avoid while taking sotalol?

Avoid taking an antacid within 2 hours before or 2 hours after you take sotalol. Some antacids can make it harder for your body to absorb sotalol.

What other drugs will affect sotalol?

Tell your doctor about all your other medicines, especially:

This list is not complete. Other drugs may affect sotalol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Does sotalol interact with my other drugs?

Enter medications to view a detailed interaction report using our Drug Interaction Checker.

Storage

Store at room temperature away from moisture and heat.

Keep out of reach of children.

Ingredients

Depends on the manufacturer. An example given is for sotalol USP labeled by Rebel Distributors Corp.

Active: sotalol hydrochloride 80 mg, 120 mg, 160 mg, or 240 mg

Inactive: colloidal silicon dioxide, FD&C blue No. 1 aluminum lake, hydroxypropyl cellulose, lactose anhydrous, lactose monohydrate, magnesium stearate, pregelatinized starch, and sodium starch glycolate.

Popular FAQ

What's the difference between Sotalol and Sotalol AF?

Sotalol AF is specifically used for maintenance of normal sinus rhythm [delay in time to recurrence of atrial fibrillation/atrial flutter (AFIB/AFL)] in patients with symptomatic AFIB/AFL who are currently in sinus rhythm. Plain Sotalol is not approved for AFIB/AFL indication and should not be substituted for Sotalol AF because only Sotalol AF is distributed with a patient package insert that is appropriate for patients with AFIB/AFL. Continue reading

References

  1. Product information

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.