Sotalol

1 What is Sotalol?

Generic: Sotalol (Intravenous Route)

Sotalol injection is used to control rapid heartbeats and abnormal heart rhythms that are serious or life-threatening. Sotalol is a beta-blocker and antiarrhythmic. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and at a regular rhythm.

Sotalol is available in two form. Sotalol is prescribed to patients with ventricular tachycardia or ventricular fibrillation. Another form is called Sotalol AF, is given to patients with atrial fibrillation or atrial flutter.

Sotalol and Sotalol AF are available in injectable form and oral tablets. This section discusses Sotalol injection.

You can only purchase both Sotalol with doctor's prescription.

Sotalol should be used only with doctor's supervision, especially when first time taking it, to prevent the risk of serious heart problems.

2 What to Know Before Using

The doctor will consider the following before prescribing Sotalol.

Allergies

You cannot use Sotalol if you are allergic to it.

Use on children

Sotalol cannot be given to children or patients below 18 years old.

Use on elderly

Sotalol should be used with caution in elderly, especially those with heart or lung conditions.

Health conditions

Sotalol is not suitable for patients with serious heart or lung conditions. You cannot use Sotalol if you have any of the following health problems:

  • Irregular heartbeat conditions such as long QT syndrome, prolonged QT interval, sick sinus syndrome, or second- or third-degree heart block
  • Having any irregular heartbeat conditions and not having a permanent pacemaker
  • Shock caused by serious heart problems such as heart failure
  • Uncontrolled heart failure
  • Very slow heartbeat
  • Low levels of potassium or magnesium in the blood
  • Severe kidney disease
  • Asthma
  • Serious lung problems that cause wheezing or shortness of breath
  • Will undergo surgery shortly

Drug interactions

Sotalol can interact with certain drugs and cause serious adverse effects. You can avoid this by stating all of the medicines you take before taking Sotalol. You cannot take Sotalol if you are taking any of the following drugs:

  • Any drug that already contains Sotalol
  • Certain drugs used to treat irregular heartbeats (antiarrhythmics) such as Amiodarone, Disopyramide, Dofetilide, Procainamide, and Quinidine.
  • Tricyclic antidepressants such as Amitriptyline, Amoxapine, Clomipramine, Desipramine, Doxepin, Imipramine, Nortryptiline, and Protriptyline, and others.
  • Any drug that causes irregular heartbeat or prolonged QT interval, such as drugs used to treat mental illnesses, and antidepressants.
  • Diphenhydramine
  • Astemizole
  • Loratidine
  • Terfanide
  • Chloroquine
  • Quinine
  • Erythromycin
  • Clarithromycin

The following drugs can be taken with Sotalol with proper precaution. Tell your doctor if you use any of the following drugs before taking Sotalol:

  • Calcium channel blockers such as Diltiazem and Verapamil
  • Clonidine
  • Digoxin
  • Water pills such as Furosemide or Hydrochlorothiazide
  • Drugs for treating irregular heartbeats such as Dronedarone and Propafenone
  • Any antibiotic
  • Drugs for treating mental illnesses or depression
  • Albuterol
  • Isoproterenol
  • Terbutaline
  • Epinephrine for allergic problems
  • Insulin
  • Antidiabetic medication

Alcohol use

You cannot take alcohol if you are taking Sotalol.

Pregnancy

Sotalol is an FDA pregnancy category B drug, which means it may be somewhat safe to the fetus when given to pregnant patients. However, you must first notify your doctor if you are pregnant before taking Sotalol.

Breastfeeding

Do not breastfeed when taking Sotalol. Sotalol can be expressed into breastmilk and harm the nursing baby. 

3 Proper Usage

Sotalol Injection is given by injecting into your veins (intravenous route). The doctor will determine the form of Sotalol, which is either Sotalol or Sotalol AF, you will use. Sotalol and Sotalol AF are not interchangeable, and you must only take the form prescribed to you.

Sotalol Injection can be given once or twice a day. You will have to be in the hospital or doctor’s clinic when taking Sotalol Injection. You will be closely monitored for the first few doses of Sotalol. You cannot take Sotalol injection at home.

Your doctor will order you to have regular lab tests such as electrocardiogram (ECG) frequently when you are taking Sotalol.

Because health professionals will prepare and give Sotalol Injection, missing a dose and overdose is very unlikely. 

4 Precautions to Take

You must be monitored when taking Sotalol. The doctor will order you to frequently visit the clinic and have lab tests while taking Sotalol. Make sure not to miss doctor appointments and lab tests.

It is very important not to skip doses or discontinue use of Sotalol without doctor’s advice. Doing so can trigger serious symptoms and make your condition worse. If you missed an injection of Sotalol, call the doctor right away.

Antacids makes it harder for your body to absorb Sotalol. If you are taking antacids, take them 2 hours before or 2 hours after taking Sotalol.

Sotalol may cause your blood pressure to become very low. The doctor may recommend you to measure blood pressure level by your own using a sphygmomanometer or digital devices at home. Call your doctor right away if your blood pressure drops to below 100/60 mmHg or if you experience symptoms.

Call the doctor if you have conditions such as dehydration, excess sweating, illness with frequent vomiting or diarrhea, or prolonged illness. These conditions can cause electrolyte imbalance, which makes it dangerous for you to have Sotalol.

If you will undergo surgery or lab tests, make sure to tell your healthcare providers that you use Sotalol. You may have to stop taking Sotalol for a while.

When you are receiving Sotalol, do not take any other medication or supplement unless prescribed by the doctor.

5 Potential Side Effects

Sotalol can cause serious side effects that require medical attention. Call your doctor immediately if you experienced any of the following:

  • Serious allergic reaction symptoms such as difficulty breathing, skin rash, hives, swelling of the face, mouth, throat, or tongue.
  • Headache with chest pain, severe dizziness or fainting, fast or pounding heartbeats
  • Very slow heartbeats
  • Lightheadedness or fainting
  • Trouble breathing
  • Severe diarrhea
  • Severe vomiting or loss of appetite
  • Dryness of the mouth
  • Unusual or profuse sweating
  • Increased thirst
  • Swelling or rapid weight gain

Sotalol may cause minor side effects such as:

  • Headache
  • Dizziness
  • Tiredness
  • Slowed heartbeats
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