II. Indications
- Ventricular Arrhythmia
-
Atrial Fibrillation Cardioversion (or Atrial Flutter)
- Time to Cardioversion: 3-6 hours
- Conversion Rate: 20-52%
- Chronic Efficacy: 50-60%
III. Mechanism
- Class III Antiarrhythmic
- Prolongs Action Potential duration
- Prolongs cardiac tissue refractory period throughout heart Muscle
- Class II Antiarrhythmic
- Non-selective Beta Blocker
IV. Precautions
- Proarrhythmic with risk of Torsades de Pointes
- Initiate in monitored setting capable of cardiac Resuscitation
- Monitoring
- Telemetry
- Renal Function (GFR)
V. Dosing
- Precautions
- Different formulations (Betapace, Betapace AF and Sotylize solution) are NOT equivalent
- Adjust dose in Renal Insufficiency
- Ventricular Arrhythmia (Betapace, Sotylize)
- Start 80 mg orally twice daily
- Target: 80-160 mg orally twice daily
- Maximum: 640 mg per day (Betapace), 320 mg/day (Sotylize)
-
Atrial Fibrillation Rhythm Control (Betapace AF, Sotylize)
- Start 80 mg orally twice daily
- Target: 80-160 mg orally twice daily
- Maximum: 640 mg per day (Betapace AF), 160 mg/day (Sotylize)
VI. Adverse Effects
- Hypotension
-
Torsades de Pointes
- Associated with doses over 320 mg per day
- Higher risk in Congestive Heart Failure and female gender
VII. Safety
- Pregnancy Category B
- Avoid in Lactation
VIII. Resources
IX. References
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 78-9
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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Related Studies
sotalol (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
SOTALOL 120 MG TABLET | Generic | $0.10 each |
SOTALOL 160 MG TABLET | Generic | $0.16 each |
SOTALOL 80 MG TABLET | Generic | $0.08 each |
SOTALOL AF 120 MG TABLET | Generic | $0.10 each |
SOTALOL AF 160 MG TABLET | Generic | $0.16 each |
SOTALOL AF 80 MG TABLET | Generic | $0.08 each |
Ontology: Sotalol (C0037707)
Definition (NCI) | An ethanolamine derivative with Class III antiarrhythmic and antihypertensive properties. Sotalol is a nonselective beta-adrenergic receptor and potassium channel antagonist. In the heart, this agent inhibits chronotropic and inotropic effects thereby slowing the heart rate and decreasing myocardial contractility. This agent also reduces sinus rate, slows conduction in the atria and in the atrioventricular (AV) node and increases the functional refractory period of the AV node. |
Definition (MSH) | An adrenergic beta-antagonist that is used in the treatment of life-threatening arrhythmias. |
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
MSH | D013015 |
SnomedCT | 372911006, 96301002 |
LNC | LP16279-9, MTHU003385 |
English | Sotalol, Methanesulfonamide, N-(4-(1-hydroxy-2-((1-methylethyl)amino)ethyl)phenyl)-, sotalol, Sotalol [Chemical/Ingredient], antiarrhythmics sotalol, sotalol (medication), SOTALOL, Sotalol (product), Sotalol (substance) |
Swedish | Sotalol |
Czech | sotalol |
Finnish | Sotaloli |
Russian | SOTALOL, СОТАЛОЛ |
Japanese | ソタロール |
Polish | Sotalol |
Spanish | sotalol (producto), sotalol (sustancia), sotalol, Sotalol |
French | Sotalol |
German | Sotalol |
Italian | Sotalolo |
Portuguese | Sotalol |
Ontology: Betapace (C0728751)
Concepts | Pharmacologic Substance (T121) , Organic Chemical (T109) |
English | Betapace, betapace |