Sotalol

1 medicine

Sotalol is a beta-blocker with class III antiarrhythmic effects used to control irregular heart rhythms. Because it can prolong the QT interval and trigger a dangerous rhythm, treatment is started in hospital with continuous ECG monitoring.

Betapace

Sotalol

40mg

Betapace is a heart blood pressure medication containing Sotalol, available as 40mg tablets.

from $1.00 / tablet View

Key facts

  • Sotalol (sold as Betapace and generics) is a beta-blocker with additional class III antiarrhythmic effects, used to control irregular heart rhythms.
  • Treatment is started, and any dose increase is made, in hospital with continuous ECG monitoring, because sotalol can prolong the QT interval and trigger a dangerous rhythm called torsades de pointes.
  • You take it on an empty stomach at evenly spaced times, exactly as prescribed; never double up a missed dose.
  • Seek urgent care for fainting, a very slow or irregular pulse, or palpitations with dizziness.

What sotalol treats

Sotalol treats atrial fibrillation and atrial flutter (rapid, irregular upper-chamber rhythms) and certain life-threatening ventricular arrhythmias. It is also used to help keep a normal rhythm after it has been restored by cardioversion.

How sotalol works

Sotalol blocks beta receptors, reducing the heart's response to adrenaline and slowing the heart rate. It also blocks potassium channels in heart muscle cells, which prolongs the electrical recovery time between heartbeats, the QT interval, and helps stop abnormal rhythms from starting. This second action is powerful, and it is also what creates the risk of a new, dangerous rhythm.

Before you take it

  • Sotalol is not started outside hospital; your care team monitors your ECG and blood levels of potassium and magnesium during the first days of treatment and after any dose change.
  • Tell your doctor about asthma, a slow heart rate, heart block, or kidney impairment, since sotalol is cleared by the kidneys and dose reduction is often needed.
  • Low potassium or magnesium, from diuretics, vomiting, or diarrhoea, raises the risk of dangerous rhythms; these are corrected before and during treatment.
  • Other QT-prolonging drugs, including certain antihistamines, antipsychotics, and antibiotics, increase risk when combined with sotalol.

Side effects

Common effects include fatigue, light-headedness, a slower heartbeat, and shortness of breath on exertion.

Stop and seek urgent medical care for:

  • Fainting or near-fainting.
  • A very slow, very fast, or irregular pulse.
  • Palpitations with dizziness or chest pain.
  • Severe swelling of the legs or ankles, or worsening breathlessness.

Safety essentials

  • Sotalol is proarrhythmic: it can cause the same dangerous rhythms it is meant to prevent, especially soon after starting or increasing the dose. That is why treatment is started in hospital with ECG monitoring.
  • Blood potassium and magnesium, kidney function, and the QT interval are checked regularly throughout treatment.
  • Never stop sotalol suddenly without medical advice; abrupt withdrawal can worsen underlying heart problems in some people.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.