sotalol hydrochloride at a glance
Medicine class
Non-selective beta blocker and class III antiarrhythmic.
Main role
Treatment or prevention of selected abnormal heart rhythms.
Important checks
ECG, kidney function, potassium, magnesium and interacting medicines require review.
Administration
Swallow the tablet with water and take it consistently in relation to food.
What is sotalol hydrochloride used for?
The selected UK product is licensed for specified ventricular and supraventricular arrhythmias.
Treatment of life-threatening ventricular tachyarrhythmias.
Treatment of symptomatic non-sustained ventricular tachyarrhythmias.
Prevention of paroxysmal atrial tachycardia, atrial fibrillation, atrioventricular nodal re-entry tachycardia and atrioventricular re-entry tachycardia involving accessory pathways.
Prevention of paroxysmal supraventricular tachycardia after cardiac surgery.
Maintenance of sinus rhythm after atrial fibrillation or atrial flutter has been converted.
How does sotalol hydrochloride work?
Sotalol blocks beta receptors, slowing the heart and reducing adrenergic stimulation. It also delays cardiac repolarisation, lengthening the refractory period during which heart tissue cannot be re-excited. This dual action can suppress arrhythmias but may also prolong the QT interval and occasionally provoke a dangerous rhythm.
sotalol hydrochloride preparations and strengths
Tablet
Route: Oral
Strengths: 40 mg, 80 mg
How to take sotalol hydrochloride
Take sotalol exactly as prescribed and follow the dispensing label. Swallow tablets with water; they may be taken with or without food, but use the same approach each day because food can alter absorption.
Do not stop sotalol suddenly without speaking to the prescriber.
Do not drive, cycle or operate machinery if it causes dizziness or tiredness.
Check before starting non-prescription or herbal products.
sotalol hydrochloride side effects
Common or expected effects
- Tiredness, dizziness, weakness or headache
- Slow heartbeat, low blood pressure or palpitations
- Breathlessness
- Nausea, vomiting, diarrhoea, indigestion or abdominal discomfort
- Cold hands or feet
- Sleep or mood changes
- Rash or visual disturbance
Get urgent medical advice
- A new or worsening abnormal rhythm, including palpitations with dizziness or fainting
- Chest pain
- Severe breathlessness, wheezing or swelling suggesting cardiac or respiratory deterioration
- Unexplained bruising or bleeding
- A severe allergic reaction with facial or throat swelling or breathing difficulty
sotalol hydrochloride in pregnancy
Sotalol can be used during pregnancy when a clinician considers it necessary; do not stop it without specialist advice. Extra fetal-growth scans may be offered. Exposure later in pregnancy can occasionally cause temporary slow heart rate or low blood glucose in the newborn, so the maternity and neonatal teams should know about treatment.
sotalol hydrochloride while breastfeeding
Sotalol can pass into breast milk in relatively high amounts. The selected product information does not recommend breastfeeding during treatment, while NHS sources advise that use may sometimes be considered after an individual specialist assessment. A breastfed infant may need observation for poor feeding, inadequate weight gain, unusual sleepiness, pallor, vomiting or diarrhoea.
sotalol hydrochloride interactions
Check all prescribed, non-prescription and complementary products because interactions may affect heart rhythm, blood pressure or electrolytes.
Amiodarone, quinidine, disopyramide and other antiarrhythmics
Combined electrical and heart-rate effects can increase QT prolongation, bradycardia and serious arrhythmia risk.
QT-prolonging antibiotics or antidepressants
Medicines such as macrolide antibiotics, quinolones, citalopram or tricyclic antidepressants can increase dangerous rhythm risk.
Verapamil or diltiazem
Additive effects may cause marked bradycardia, low blood pressure, conduction block or heart failure.
Common questions about sotalol hydrochloride
Answers are fully visible for fast scanning and source review.
Why is sotalol different from many other beta blockers?
In addition to beta blockade, sotalol delays cardiac repolarisation. This makes it useful for selected arrhythmias but also creates a risk of QT prolongation and proarrhythmia.
Can sotalol make an abnormal heart rhythm worse?
Yes. It can occasionally provoke a new or more serious rhythm, including torsades de pointes, particularly when the QT interval is prolonged or potassium or magnesium is low.
Why do people taking sotalol need ECGs and blood tests?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.