Details About Generic Salt ::  Sotalol

Main Medicine Class:: Beta-adrenergic blocker   

(SOTT-uh-lahl HIGH-droe-KLOR-ide)
Betapace, Betapace AF, Sotalol HCl
Class: Beta-adrenergic blocker


Drugs Class ::

 Action Blocks beta receptors, which primarily affect heart (slows rate), vascular musculature (decreases blood pressure), and lungs (reduces function).

Indications for Drugs ::

 Indications Betapace: Management or prevention of life-threatening ventricular arrhythmias. Betapace AF: Maintenance of normal sinus rhythm in patients with highly symptomatic atrial fibrillation/atrial flutter (AFIB/AFL) (Betapace AF).

Drug Dose ::


Betapace should not be substituted for Betapace AF because of significant differences in labeling (eg, patient package insert, dosing administration and safety information). Betapace:

Ventricular Arrhythmias

ADULTS: PO 80 mg twice daily; may increase up to 320 mg/day in 2 or 3 divided doses. Patients with a history of symptomatic AFIB/AFL currently receiving Betapace should be transferred to Betapace AF because of the significant differences in labeling. Betapace AF: Therapy with Betapace AF must be initiated and, if necessary, titrated in a setting that provides continuous ECG monitoring and in the presence of personnel trained in the management of serious ventricular arrhythmias. Monitor patients in this way for a min of 3 days on the maintenance dose and do not discharge within 12 hr of electrical or pharmacological conversion to normal sinus rhythm.

ADULTS: PO Initiate therapy at 80 mg twice daily if Ccr is > 60 mL/min, and 80 mg q 4 hr if the Ccr is 40 to 60 mL/min. Begin continuous ECG monitoring with QT interval measurements 2 to 4 hr after each dose. If the 80 mg dose level is tolerated and QT interval remains < 500 msec after ³ 3 days, the patient may be discharged. Alternatively, during hospitalization, if 80 mg level does not reduce the frequency of relapse of AFIB/AFL and is tolerated without excessive QT interval prolongation (ie, > 520 msec), after following the patient for 3 days, the dose level may be increased to 120 mg (q 2 or 4 hr depending on Ccr). The max recommended dose in patients with Ccr > 60 mL/min is 160 mg twice daily.

Contraindication ::

 Contraindications Betapace: Hypersensitivity to beta-blockers; greater than first-degree heart block; CHF unless secondary to tachyarrhythmia treatable with beta-blockers; overt cardiac failure; sinus bradycardia; cardiogenic shock; bronchial asthma or bronchospasm, including severe COPD; congenital or acquired long QT syndromes. Betapace AF: Sinus bradycardia (< 50 bpm during waking hr); sick sinus syndrome or second and third degree AV block (unless a functioning pacemaker is present); congenital or acquired QT syndromes; baseline QT interval > 450 msec; cardiogenic shock; uncontrolled heart failure; hypokalemia (< 4 mEq/L); creatinine clearance < 40 mL/min; bronchial asthma; previous evidence of hypersensitivity to sotalol.

Drug Precautions ::


Pregnancy: Category B. Lactation: Excreted in breast milk. Children: Safety and efficacy not established. Abrupt withdrawal: Has been associated with adverse effects; gradually decrease dose over 1 to 2 wk. Anaphylaxis: Deaths have occurred; aggressive therapy may be required. CHF: Administer cautiously in patients with CHF controlled by digitalis and diuretics. Diabetic patients: Drug may mask signs and symptoms of hypoglycemia (eg, tachycardia, BP changes). Drug may potentiate insulin-induced hypoglycemia. Nonallergic bronchospasm: Give drug with caution in patients with bronchospastic disease. Peripheral vascular disease: May precipitate or aggravate symptoms of atrial insufficiency. Proarrhythmia: May provoke new or worsened arrhythmias. Correct hypokalemia or hypomagnesemia before administering sotalol. Anticipate proarrhythmic events with initial dose and with every dose adjustment. Renal/Hepatic function impairment: Alteration of dosage interval and reduced daily dose are advised. Thyrotoxicosis: May mask clinical signs (eg, tachycardia) of developing or continuing hyperthyroidism. Abrupt withdrawal may exacerbate symptoms of hyperthyroidism, including thyroid storm.


Drug Side Effects ::

 Adverse Reactions

CV: Arrhythmias; sustained ventricular tachycardia or fibrillation; torsades de pointes. CNS: Depression; dizziness; headache; lethargy; paresthesias; vivid dreams. DERM: Rash. GI: Anorexia; constipation; diarrhea; dry mouth; dyspepsia; flatulence; nausea; vomiting. GU: Decreased libido; dysuria; impotence; nocturia; urinary retention or frequency; urinary tract infection. HEPA: Elevated liver enzymes. META: May increase or decrease blood glucose. RESP: Bronchospasm; difficulty breathing; wheezing.

Drug Mode of Action ::  

 Action Blocks beta receptors, which primarily affect heart (slows rate), vascular musculature (decreases blood pressure), and lungs (reduces function).

Drug Interactions ::


Amiodarone, disopyramide, procainamide, quinidine: May prolong cardiac refractoriness. Calcium channel blockers: Increase risk of hypotension; possible increased effect on atrioventricular conduction or ventricular function. Clonidine: May enhance or reverse antihypertensive effects; may enhance clonidine rebound hypertension. Guanethidine, reserpine: Increase hypotension or bradycardia. Insulin, oral sulfonylurea hypoglycemic agents: Hyperglycemia; symptoms of hypoglycemia may be masked. NSAIDs: Some agents may impair antihypertensive effect.

Drug Assesment ::


  • Obtain patient history, including drug history and any known allergies.
  • Obtain complete cardiac assessment prior to initiation of therapy.
  • Closely monitor patient during initiation of therapy and with each dosage change.
  • Monitor pulse and BP, ECG, and heart rate and rhythm routinely.
  • Monitor potassium, magnesium, and glucose levels routinely.
  • Assess apical pulse and blood pressure prior to each dose.
  • If extremes in pulse rates are detected, withhold medication and call physician immediately.
  • Notify physician immediately of any signs of CHF or of any unexplained respiratory symptoms.

  Bradycardia, CHF, hypotension, bronchospasm, prolongation of QT interval, torsades de pointes, ventricular tachycardia, premature ventricular complexes, hypoglycemia

Drug Storage/Management ::


  • Adjust dosage gradually to attain steady-state plasma concentrations.
  • Before initiating therapy, carefully monitor response to withdrawal of previous antiarrhythmic therapy.
  • Give on empty stomach.
  • Store at room temperature.

Drug Notes ::

 Patient/Family Education

  • Explain importance of not discontinuing drug suddenly, and advise that dosage will be decreased over 1 to 2 wk.
  • Explain that drug may mask signs and symptoms of hypoglycemia.
  • Teach patient to take pulse daily and to notify physician if pulse drops below 60.
  • Tell patient to call physician if adverse reaction occurs.
  • Instruct patient not to take otc medications without consulting physician.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.


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