Sotalol (Oral)

Sotalol is a beta-blocker drug used in the treatment of arrhythmia (abnormal heart rhythm). It is only recommended to treat serious cases of arrhythmia.

Overview

Sotalol is a type of medication that is prescribed for the treatment of ventricular arrhythmia, which is a potentially life-threatening problem affecting a patient’s heart rhythm. It can also be used in the treatment of other problems affecting heart rhythms, such as atrial flutter and atrial fibrillation.

Sotalol is a member of the beta-blocker family of drugs. It creates its effect by altering the response of impulses in the nerves at particular areas of the body, such as the heart. As a consequence of the medication, the patient’s heart will beat at a regular rhythm, and slower.

Sotalol is classified as a non-selective drug, being a competitive blocker of beta-adrenergic receptors, which also demonstrates properties of a Class III antiarrhythmic medication.

Studies by the FDA into sotalol discovered that the drug prolongs the QT interval and, as such, carries the slight risk of prompting a life-threatening form of polymorphic ventricular tachycardia, also identified as torsades de pointes. As a consequence, it is only ever prescribed for the treatment of extreme cases of ventricular arrhythmia.

Sotalol is only available with a prescription from your doctor.

Sotalol is available in the following forms:

  • Tablet
  • Solution

Conditions Treated

  • Severe ventricular arrhythmia
  • Atrial fibrillation
  • Atrial flutter

Type of Medicine

  • Antiarrhythmia
  • Beta-blocker

Side Effects

Alongside its expected and desired effects, any medication might result in some less desirable effects. Whilst there is no guarantee that all of the side effects (or any of them) might occur, should any of them do so you may require medical attention.

Immediately consult your prescribing doctor should any of these side effects listed exhibit themselves:

  • Blurred vision
  • Weight gain
  • Unusual weakness or tiredness
  • Tightness in the chest
  • Swelling of the lower legs, feet, fingers, or face
  • Sweating
  • Slow speech
  • Pounding noises in the patient’s ears
  • Red pinpoint spots appearing on the skin
  • Difficult, burning, or painful urination
  • Noisy breathing
  • Nervousness
  • Vomiting and nausea
  • Side or lower back pain
  • Loss of voice
  • Fainting, dizziness, or light-headedness
  • Joint swelling or pain
  • Irregular breathing
  • Unable to speak
  • Unable to move facials muscles, legs, or arms
  • Headache
  • Reddening or flushing to the skin, particularly about the neck and face
  • Chills or fever
  • Feelings of heat or warmth
  • Racing, pounding, irregular, slow, or fast pulse or heartbeat
  • Fast breathing
  • Extreme fatigue
  • Double vision
  • Light-headedness, faintness, or dizziness when suddenly rising from a seated or prone position
  • Dilated veins in the neck
  • Difficulty when speaking
  • Labored or difficult breathing
  • Decreased alertness
  • Hoarseness or cough
  • Confusion
  • Chest discomfort or pain
  • Tingling, pins and needles, prickling, numbness, itching, crawling, or burning feelings
  • Body pain or aches
  • Stomach or abdominal swelling or pain

Listed below are the symptoms you can expect in the event of an overdose:

  • Anxiety
  • Slurred speech
  • Shakiness
  • Seizures
  • Nightmares
  • Increased hunger
  • Depression
  • Pale, cool skin
  • Cold sweats

Should any of these symptoms exhibit themselves during your course of treatment, it is essential that you seek immediate emergency help.

The effects listed above might require the attention of a medical expert. However, other side effects might also present themselves, which do not require medical attention. Many of these effects should disappear throughout your course of treatment, while your body becomes acclimatized to the medication. Additionally, your prescribing doctor might be able to recommend a way to reduce or prevent all (or at least some) of the potential negative effects.

Should any of the side effects listed below continue throughout your course of treatment, or should they become bothersome to you, you ought to consult your doctor:

  • Sour or acid stomach
  • Weight changes
  • Skin rash
  • Severe sunburn
  • Spinning sensation
  • Quickness to overreact or react emotionally
  • Passing gas
  • Pain to the legs or arms
  • Night blindness
  • Muscle stiffness or pains
  • Muscle cramping or aching
  • Mood changes
  • Loss or lack of appetite
  • Itching skin
  • Indigestion or heartburn
  • Thinning of hair, or hair loss
  • Sensation that one’s surroundings or self are in a constant state of movement
  • Insomnia, or difficulty whilst sleeping
  • Decreased sexual desire or performance
  • Changes to vision

The effects listed above are not exhaustive, and there might be other negative impacts that present themselves as a result of taking sotalol. If you become aware of any negative effects during your course of treatment with sotalol, be sure to speak with your doctor.

Dosage

The dosage recommended of sotalol differs from one patient to the next. You must always follow the directions of your prescribing doctor or the instructions printed on your medication’s label. The information listed below indicates the average dosages of sotalol, and should not be taken as medical advice. Should your doctor prescribe a dosage that differs from those listed here, you must not alter them unless explicitly advised to by your examining doctor.

The amount of sotalol you take will depend upon how strong the medicine is. Additionally, the time you should allow to elapse between doses, the amount of doses that you take every day, and how long your course of sotalol will last depends entirely upon the nature of the medical condition for which it has been prescribed.

For oral dosage (tablets or solution):

For abnormal heart rhythms:

Adults – initially, 80 milligrams (mg) once or twice per day. Your prescribing doctor might choose to amend the dosage every three days, if necessary.

Children – the use and dosage of sotalol must be decided upon by your prescribing doctor.

If you happen to miss a dosage of sotalol, you should take it at the earliest opportunity. However, should it be nearly time for the next dosage, you ought to skip your missed dosage and return to your normal schedule of dosing. Under no circumstances should you double the dose.

Interactions

Whilst there are some medications that ought never be utilized alongside one another, in any event, there might be other circumstances where a pair of different drugs can be taken concurrently, even though an interaction is known likely to occur. In such a situation, your prescribing doctor might choose to amend your dosage, or could recommend further precautions. Whilst taking sotalol, it is essential that your examining doctor is aware that you take any other medication, particularly the ones that are listed beneath. These interactions are listed here based on the likelihood of their occurrence and potential significance. This list is not necessarily exhaustive.

Using sotalol alongside one or more of the following medications cannot be recommended:

  • Amifampridine
  • Ziprasidone
  • Vernakalant
  • Thioridazine
  • Terfenadine
  • Sparfloxacin
  • Saquinavir
  • Piperaquine
  • Pimozide
  • Mesoridazine
  • Levomethadyl
  • Grepafloxacin
  • Fingolimod
  • Dronedarone
  • Cisapride
  • Bepridil
  • Amisulpride

Your prescribing doctor might choose to not treat your condition with sotalol, or may instead choose to alter the other drugs you have been prescribed.

Using sotalol alongside the following drugs is normally not recommended:

  • Acecainide
  • Zuclopenthixol
  • Zotepine
  • Zolmitriptan
  • Xipamide
  • Vorinostat
  • Voriconazole
  • Vinflunine
  • Vilanterol
  • Verapamil
  • Venlafaxine
  • Vemurafenib
  • Vasopressin
  • Vardenafil
  • Vandetanib
  • Triptorelin
  • Trimipramine
  • Trimethoprim
  • Trifluoperazine
  • Trichlormethiazide
  • Triamterene
  • Trazodone
  • Torsemide
  • Toremifene
  • Tolterodine
  • Tocainide
  • Tizanidine
  • Ticrynafen
  • Tetrabenazine
  • Telithromycin
  • Telavancin
  • Telaprevir
  • Tamoxifen
  • Tacrolimus
  • Sunitinib
  • Sultopride
  • Sulpiride
  • Sulfamethoxazole
  • Spironolactone
  • Spiramycin
  • Sorafenib
  • Solifenacin
  • Sodium Phosphate, Monobasic
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate
  • Sevoflurane
  • Sertindole
  • Rivastigmine
  • Ritonavir
  • Risperidone
  • Ranolazine
  • Quinine
  • Quinidine
  • Quinethazone
  • Quetiapine
  • Protriptyline
  • Propafenone
  • Promethazine
  • Prochlorperazine
  • Procainamide
  • Probucol
  • Prilocaine
  • Posaconazole
  • Polythiazide
  • Pitolisant
  • Piretanide
  • Pipamperone
  • Pimavanserin
  • Perphenazine
  • Perflutren Lipid Microsphere
  • Pentamidine
  • Pazopanib
  • Pasireotide
  • Paroxetine
  • Papaverine
  • Panobinostat
  • Paliperidone
  • Oxymetazoline
  • Ondansetron
  • Olanzapine
  • Ofloxacin
  • Octreotide
  • Nortriptyline
  • Norfloxacin
  • Nilotinib
  • Nelfinavir
  • Nafarelin
  • Moxifloxacin
  • Moricizine
  • Mizolastine
  • Mifepristone
  • Mexiletine
  • Metronidazole
  • Metolazone
  • Methotrimeprazine
  • Methadone
  • Mefloquine
  • Mannitol
  • Lumefantrine
  • Lopinavir
  • Lidoflazine
  • Lidocaine
  • Levofloxacin
  • Leuprolide
  • Lapatinib
  • Lacosamide
  • Ketoconazole
  • Ivabradine
  • Itraconazole
  • Isradipine
  • Isoflurane
  • Indecainide
  • Indapamide
  • Imipramine
  • Iloperidone
  • Ibutilide
  • Hydroxyzine
  • Hydroxychloroquine
  • Hydroquinidine
  • Hydroflumethiazide
  • Hydrochlorothiazide
  • Histrelin
  • Halothane
  • Haloperidol
  • Halofantrine
  • Granisetron
  • Goserelin
  • Gonadorelin
  • Gemifloxacin
  • Gatifloxacin
  • Galantamine
  • Furosemide
  • Fosphenytoin
  • Foscarnet
  • Formoterol
  • Fluoxetine
  • Fluconazole
  • Flecainide
  • Fenquizone
  • Fenoldopam
  • Felbamate
  • Famotidine
  • Etozolin
  • Ethacrynic Acid
  • Escitalopram
  • Erythromycin
  • Eribulin
  • Epinephrine
  • Enflurane
  • Encainide
  • Efavirenz
  • Ebastine
  • Droperidol
  • Doxepin
  • Donepezil
  • Domperidone
  • Dolasetron
  • Dofetilide
  • Disopyramide
  • Diltiazem
  • Digoxin
  • Dibenzepin
  • Deslorelin
  • Desipramine
  • Delamanid
  • Degarelix
  • Dasatinib
  • Dabrafenib
  • Cyclothiazide
  • Cyclobenzaprine
  • Crizotinib
  • Clozapine
  • Clopamide
  • Clonidine
  • Clomipramine
  • Clarithromycin
  • Citalopram
  • Ciprofloxacin
  • Chlorthalidone
  • Chlorpromazine
  • Chloroquine
  • Chloral Hydrate
  • Canrenoate
  • Buserelin
  • Bumetanide
  • Benzthiazide
  • Bendroflumethiazide
  • Bemetizide
  • Bedaquiline
  • Azosemide
  • Azithromycin
  • Astemizole
  • Asenapine
  • Artemether
  • Arsenic Trioxide
  • Aripiprazole
  • Apomorphine
  • Anagrelide
  • Amoxapine
  • Amitriptyline
  • Amiodarone
  • Amiloride
  • Alfuzosin
  • Acetazolamide

However, it might be necessary to combine them in some circumstances. Should both medications be prescribed at the same time, your prescribing doctor might amend the dosage of sotalol, or the other drug, or they might choose to amend how often a dosage should be taken.

Using sotalol alongside the following drugs has been shown to risk an increase in exhibited particular side effects:

  • Abarelix
  • Vildagliptin
  • Valdecoxib
  • Urapidil
  • Trimazosin
  • Tolmetin
  • Tolfenamic Acid
  • Tolbutamide
  • Tolazamide
  • Tiaprofenic Acid
  • Terazosin
  • Tenoxicam
  • Tamsulosin
  • Sulindac
  • St John's Wort
  • Sodium Salicylate
  • Sitagliptin
  • Saxagliptin
  • Salsalate
  • Salicylic Acid
  • Rosiglitazone
  • Rofecoxib
  • Repaglinide
  • Proquazone
  • Propyphenazone
  • Proglumetacin
  • Prazosin
  • Pranoprofen
  • Pramlintide
  • Piroxicam
  • Pioglitazone
  • Piketoprofen
  • Phenylbutazone
  • Phentolamine
  • Phenoxybenzamine
  • Parecoxib
  • Oxyphenbutazone
  • Oxaprozin
  • Nimesulide Beta Cyclodextrin
  • Nimesulide
  • Niflumic Acid
  • Nepafenac
  • Nateglinide
  • Naproxen
  • Nabumetone
  • Moxisylyte
  • Morniflumate
  • Miglitol
  • Mibefradil
  • Methyldopa
  • Metformin
  • Meloxicam
  • Mefenamic Acid
  • Meclofenamate
  • Lumiracoxib
  • Loxoprofen
  • Lornoxicam
  • Lixisenatide
  • Liraglutide
  • Linagliptin
  • Ketorolac
  • Ketoprofen
  • Insulin Lispro, Recombinant
  • Insulin Human Regular
  • Insulin Human Isophane (NPH)
  • Insulin Human Inhaled
  • Insulin Glulisine
  • Insulin Glargine, Recombinant
  • Insulin Detemir
  • Insulin Degludec
  • Insulin Aspart, Recombinant
  • Indomethacin
  • Ibuprofen
  • Glyburide
  • Glipizide
  • Glimepiride
  • Flurbiprofen
  • Flufenamic Acid
  • Floctafenine
  • Feprazone
  • Fepradinol
  • Fenoprofen
  • Felbinac
  • Exenatide
  • Etoricoxib
  • Etofenamate
  • Etodolac
  • Empagliflozin
  • Dulaglutide
  • Droxicam
  • Doxazosin
  • Dipyrone
  • Diflunisal
  • Diclofenac
  • Dexketoprofen
  • Dexibuprofen
  • Dapagliflozin
  • Clonixin
  • Choline Salicylate
  • Chlorpropamide
  • Celecoxib
  • Canagliflozin
  • Bunazosin
  • Bufexamac
  • Bromfenac
  • Aspirin
  • Arbutamine
  • Amtolmetin Guacil
  • Alogliptin
  • Albiglutide
  • Acemetacin
  • Aceclofenac
  • Acarbose

However, the use of both drugs concurrently might be determined by your doctor as being the most effective method of treatment for your condition. Should both drugs be prescribed at the same time, your examining doctor might choose to alter the dosage, or the regularity of dosage for either of the medications, or both of them.

Some drugs ought not be used at the time of eating, or around that time, or ought not be used whilst eating specific foodstuffs, owing to the risk of certain known interactions. Using tobacco or alcohol alongside certain drugs can also result in certain interactions occurring. If concerned about your used of tobacco, alcohol, or food during your course of treatment with sotalol, consult your prescribing doctor.

Warnings

Whenever you decide to take a drug, the risk of taking it ought to be weighed up alongside what good it can do for your condition. This decision should be reached following consultation between you and your prescribing doctor. When prescribed sotalol you ought to consider the following:

Inform your prescribing doctor, should you have suffered an allergic, or any other kind of unusual reaction to sotalol, or indeed to any other medication. You should also inform your prescribing doctor should you suffer from any other allergic or negative reactions to others things, including animals, preservatives, dyes, or foods.

There have been no appropriate studies conducted to determine the relationship between age and the impact of sotalol on the pediatric population. Your prescribing doctor will decide if sotalol is an appropriate medication for a younger patient.

Whilst studies have not shown any problems specific to the geriatric population that would preclude or limit the use of sotalol amongst elderly patients, it has been shown that geriatric patients are more prone to kidney problems that come about as a result of age. This could necessitate extra caution, or might require the prescribing doctor to adjust the dosage of sotalol for elderly patients.

No studies have been conducted among women that have demonstrated a risk in the use of sotalol to the fetus during pregnancy.

There have been no studies conducted among women to determine the risk to the nursing infant whilst using sotalol during breastfeeding. You must always weigh the possible benefits of the medication against its possible risks to your child before deciding to take sotalol whilst breastfeeding.

Take sotalol precisely as your prescribing doctor recommends. You must not take a larger dosage, nor should you take your medication more regularly, nor should you extend your course of treatment with the drug. When the supply of sotalol you have been given starts to run low, you should speak to your prescribing doctor in advance, as it is vital that you do not run out of your medication.

Sotalol ought to come with a leaflet providing patient information. Be sure that you read these instructions and that you follow them carefully. Should you have any concerns or questions, be sure to consult your doctor.

For the initial three days, sotalol will be administered at the hospital, so that medical professionals can monitor the rhythm of your heart.

If taking sotalol as an oral liquid solution, always use a marked medicine cup, oral syringe, or measuring spoon, as a standard household teaspoon might not have the capacity to hold the correct amount of medicine.

If you have also been prescribed antacids containing magnesium hydroxide or aluminum, be sure that you take it either two hours after or two hours before you take your dosage of sotalol.

You should only use the specific brand of sotalol that has been prescribed by your doctor. A different brand might not have the same effect on your condition.

It is vital that your prescribing doctor should check the progress of your treatment during regular visits in order to ensure that your prescription of sotalol works as it should. ECG, urine, and blood tests might be required in order to test for undesirable side effects.

If you suffer any changes to the rhythm of your heart, you must immediately consult your prescribing doctor. You may feel faint or dizzy, or you could have an uneven, pounding, or fast heartbeat. Ensure to make your prescribing doctor aware whether you, or any family member, has ever suffered from an issue with their heart rhythm.

Sotalol might cause dizziness. Ensure that you do not operate machinery, drive, or perform any other task that might be dangerous if you have a dizzy spell until you are sure you understand how sotalol affects you. Should you feel light-headed or dizzy, be sure to take care standing up and do so slowly.

Do not stop taking or interrupt your course of sotalol before consulting your doctor.

Sotalol has been shown to result in heart failure among certain patients.

Sotalol has been shown to result in changes to your levels of blood sugar.

Certain medical conditions can have an impact on the efficacy of sotalol. Be sure that your prescribing doctor is aware of any medical conditions you have, but particularly any of those listed here.

Sotalol should be used with caution along these medical conditions, as it can make the condition worse:

  • Angina
  • Bronchospasm
  • Recent heart attack, recent
  • Heart disease, including ischemic heart conditions, heart failure, and coronary insufficiency
  • Problems with heart rhythm, including QT prolongation
  • Hypomagnesemia (that is, low levels of magnesium in your blood)
  • Hypotension (that is, low blood pressure)

You should not use sotalol if suffering from any of the following medical conditions:

  • Asthma
  • Bradycardia (that is, slow heartbeat) untreated via pacemaker
  • Cardiogenic shock (that is, a shock which was caused following a heart attack)
  • Heart block, untreated via pacemaker
  • Uncontrolled heart failure
  • Problems with heart rhythm, including long QT syndrome
  • Hypokalemia (low levels of potassium in the blood)
  • Severe kidney disease
  • Sick sinus syndrome (a form of abnormal rhythm of the heart), untreated via pacemaker

Sotalol might conceal some symptoms and signs associated with the following conditions, and so should be used with caution:

  • Diabetes
  • Hyperthyroidism (that is, an overactive thyroid)
  • Hypoglycemia (that is, low blood sugar)

The effects of sotalol might be increased among patients suffering from the following conditions:

  • Kidney disease

This is owing to the reduced rate at which it is removed from the body.

Sotalol can result in difficult breathing among patients suffering from the following conditions:

  • Lung disease

Storage

Sotalol should always be stored away from direct light, moisture, and heat. It should be kept from freezing at room temperature and in a closed container.

Sotalol should always be kept beyond the reach of children.

If you no longer require your sotalol tablets or solution, or if they should become outdated, you should not keep them.

Be sure to consult your medical professional before disposing of any unwanted or outdated sotalol.

Summary

Sotalol is a beta-blocker prescribed for the treatment of extreme cases of ventricular arrhythmia (abnormal heart rhythm), as well as other heart conditions such as atrial flutter and atrial fibrillation.

As a beta blocker, the effect it causes is to alter the response of impulses in the nerves at particular areas of the body, including the heart, which slows the patient’s heartbeat and inducing a more regular rhythm.

Sotalol carries a slight risk of causing a life-threatening form of polymorphic ventricular tachycardia, also identified as torsades de pointes, which is why it is only prescribed in serious cases.

 

Resources
Last Reviewed:
January 29, 2018
Last Updated:
February 10, 2018