Sotalol (Betapace, Betapace AF) side effects & dosing (original) (raw)

GENERIC NAME: sotalol

BRAND NAME: Betapace, Betapace AF, Sorine, Sotylize

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

USES:

• Sotalol is used to treat abnormal heart rhythms such as ventricular arrhythmias (for example, ventricular tachycardia) that are life threatening and atrial fibrillation. It is not used for less severe abnormal heart rhythms.
• Sotalol should not be used in patients with bronchial asthma, sinus bradycardia, second and third degree AV block, unless a functioning pacemaker is present.
• It also should not be used in people with congenital or acquired long QT syndromes, cardiogenic shock, uncontrolled congestive heart failure, and people who are allergic to sotalol.

SIDE EFFECTS:

Common side effects of sotalol include:

• shortness of breath,
• dizziness,
• fatigue,
• palpitation,
• nausea,
• vomiting, and
• lightheadedness.

Other side effects that may occur include:

• edema (water retention),
• headache,
• sleep disturbances,
• diarrhea,
• extremity pain,
• itching,
• rash,
• fainting,
• anxiety,
• depression,
• impotence, and
• abnormal heart rhythm.

Possible serious side effects of sotalol include:

• mental confusion,
• slow heart rate,
• low blood pressure, and
• chest pain

Like other antiarrhythmic agents, sotalol can cause new or worsening ventricular arrhythmias (for example, ventricular tachycardia or ventricular fibrillation).

Sotalol may cause or worsen congestive heart failure, and it can block the symptoms of low blood glucose in diabetics.

IMAGES Heart Illustration Browse through our medical image collection to see illustrations of human anatomy and physiology See Images

PREPARATIONS: Tablets: 80, 120, 160, and 240 mg; oral solution: 5 mg/mL; injectable solution: 15 mg/mL

DRUG INTERACTIONS:

• Combining sotalol with beta-blockers such as atenolol (Tenormin), propranolol (Inderal), metoprolol (Lopressor), or calcium channel blockers such as verapamil (Calan, Isoptin, Verelan, Covera-HS) or diltiazem (Cardizem, Dilacor, Tiazac), may excessively slow heart rate or cause a block in the conduction of electrical impulses through the heart. Additionally, these combinations may further reduce blood pressure, possibly leading to hypotension.
• Digoxin and beta-blockers slow conduction of impulses in the heart and decrease heart rate. Combining them can increase the risk of slow heart rate.
• Sotalol may cause high blood glucose, and the dosage of insulin or antidiabetic drugs may require adjustment. It also may mask symptoms of low blood glucose (hypoglycemia).
• Administration of sotalol within 2 hours of antacids containing aluminum oxide and magnesium hydroxide may reduce blood concentrations of sotalol by 26%. This reduces the effect of sotalol. This combination should be avoided or the antacid should be taken two hours after the sotalol.

PREGNANCY AND BREASTFEEDING SAFETY: Sotalol crosses the placenta and is found in amniotic fluid. Safe use by pregnant women has not been established. Sotalol is excreted in human milk. A decision should be made whether to discontinue nursing or to discontinue the drug due to risk of adverse effects in the infant.

STORAGE: Store at room temperature, 15 C - 30 C (59 F - 86 F).

DOSING:

• For ventricular arrhythmias and supraventricular arrhythmias the recommended dose is 80 to 160 mg orally every 12 hours or 75 to 150 mg given intravenously every 12 hours.
• The recommended dose for refractory life-threatening ventricular arrhythmias is 80 to 160 mg orally every 12 hours. Doses of 160 to 640 mg/day given in divided doses every 8 to 12 hours may be required.
• The recommended dose for atrial fibrillation or flutter is 80 to 160 mg orally every 12 hours or 75 to 150 mg given intravenously every 12 hours.
• To reduce the risk of induced arrhythmia, patients should be observed for a minimum of 3 days in a facility that can provide cardiac resuscitation and continuous electrocardiographic monitoring while on their maintenance dose.
• The different formulations and brands of sotalol are not interchangeable.

DRUG CLASS AND MECHANISM:

• Sotalol is a beta-adrenergic blocking drug that is used to treat abnormal heart rhythms. Sotalol is a first generation beta blocker in a class that includes propranolol (Inderal, InnoPran), nadolol (Corgard), penbutolol sulfate (Levatol), timolol (Blocadren), and pindolol (Visken).
• These drugs differ from other beta blocking drugs because they are non-selective in nature, meaning that they block both beta-1 and beta-2 receptors on nerves and, therefore, will affect not only the heart but also the kidneys, lungs, gastrointestinal tract, liver, uterus, muscles surrounding blood vessels, and skeletal muscle.
• Norepinephrine and epinephrine (adrenaline) are chemicals released within the body that attach to receptors on several types of cells, including nerves and some muscles. Attachment changes the way the cells function, either stimulating the cells or suppressing them, in part through beta receptors.
• Sotalol prevents norepinephrine and epinephrine from binding to beta receptors on nerves. By blocking the effect of norepinephrine and epinephrine, beta blockers reduce heart rate, reduce the force of the heart's contractions, and reduce blood pressure by relaxing the muscles surrounding the blood vessels. Sotalol also directly reduces the rate at which the heart beats by reducing the rapidity of firing of the normal generator of electrical impulses in the heart (the heart's pacemaker).
• The FDA approved sotalol in October, 1992.

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Summary

Sotalol (Betapace, Betapace AF, Sorine, Sotylize) is a drug to treat abnormal heart rhythms. Sotalol reduces the firing of the hearts built-in pacemaker and it affects nerve receptors. This drug has potentially dangerous side effects and should be prescribed with caution.

Related Disease Conditions

• Atrial Fibrillation (AFib) Treatment Drugs Atrial fibrillation (AFib) is a heart rhythm disorder that causes irregular and often rapid heartbeat. The medications to treat AFib include beta-blockers, blood thinners, and heart rhythm drugs. Atrial fibrillation drugs can cause serious side effects like seizures, vision changes, shortness of breath, fainting, other abnormal heart rhythms, excessive bleeding while coughing or vomiting, blood in the stool, and bleeding into the brain.
• Atrial Flutter Atrial flutter is a problem with the atria of the heart. In atrial flutter the atria of the heart rapidly and repeatedly beat due to an anomaly in the electrical system of the heart. It is a type of arrhythmia and can be dangerous because complications can develop easily. Signs and symptoms of atrial flutter include near fainting, palpitations, mild shortness of breath, and fatigue. While the exact cause of atrial flutter is not clearly understood, it's most likely related to your health, what medical conditions you certainly have, poor diet, lack of exercise, and drinking too much alcohol. Atrial flutter is diagnosed by physical examination, medical history, and a sawtooth ECG wave pattern.

Treatment & Diagnosis

Medications & Supplements

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

References

FDA Prescribing Information