Oral sotalol 80 mg is equivalent to 75 mg of IV, and similarly, 160mg oral is equivalent to 150 mg of IV. If infusing intravenously, the recommendation is to administer the drug slowly as a rapid infusion can cause hypotension. 
|Betapace, Betapace AF, Sorine, Sotalol Hydrochloride AF, Sotylize||N/A|
|Half Life The half-life of a drug is the time taken for the plasma concentration of a drug to reduce to half its original value.|
|12 hours||13 hours|
|CSA Schedule ** View glossary of terms|
What is the difference between oral and IV sotalol?
Oral sotalol 80 mg is equivalent to 75 mg of IV, and similarly, 160mg oral is equivalent to 150 mg of IV. If infusing intravenously, the recommendation is to administer the drug slowly as a rapid infusion can cause hypotension.
Is sotalol a beta blocker?
The beta-blocking effect of sotalol is non-cardioselective, half maximal at an oral dose of about 80 mg/day and maximal at doses between 320 and 640 mg/day. Sotalol does not have partial agonist or membrane stabilizing activity.
What is the difference between sotalol isomers?
Both isomers have similar Class III antiarrhythmic effects, while the l-isomer is responsible for virtually all of the beta-blocking activity. The beta-blocking effect of Sotalol is non-cardioselective, half maximal at about 80 mg/day and maximal at doses between 320 and 640 mg/day.
What are the different sizes of sotalol hydrochloride AF tablets?
Sotalol hydrochloride AF tablets, USP are available as follows: 80 mg tablets: white to off-white, capsule shaped, scored tablets, imprinted “APO” on one side and “AF” bisect “80” on the other side. 120 mg tablets: white to off-white, capsule shaped, scored tablets, imprinted “APO” on one side and “AF” bisect “120” on the other side.
Can metoprolol replace sotalol?
Conclusion: Sotalol is a safe and effective agent for control of heart rate in digitalized patients with atrial fibrillation. Sotalol is superior to metoprolol at submaximal exercise, resulting in better rate control during daily activities.
How is sotalol different from other beta blockers?
Sotalol is a unique β-blocker that shows class II and III antiarrhythmic effects, but as a nonselective β-blocker, it lacks intrinsic sympathomimetic and membrane-stabilizing activity. Like amiodarone, sotalol prolongs the APD and increases refractoriness.
Which beta-blocker is best for atrial fibrillation?
Bisoprolol* or metoprolol succinate are first-choice beta-blockers for patients with atrial fibrillation as they are prescribed once-daily and do not require dose adjustment in patients with renal impairment. Bisoprolol is preferred as it is more cardioselective than metoprolol and may cause more bradycardia.
How do you convert beta blockers?
For this non-overlapping or abrupt switching, the current β blocker should be discontinued approximately 12 hours before the first dose of carvedilol. As mentioned, most patients can be initially switched to 6.25 mg or 12.5 mg b.i.d. and then up-titrated at 1–2 week intervals (Table I).
What is the safest antiarrhythmic drug?
Of all antiarrhythmic agents, dofetilide and amiodarone have been proven safe in patients with heart failure.
What is the drug of choice for atrial fibrillation?
Beta blockers and calcium channel blockers are the drugs of choice because they provide rapid rate control. These drugs are effective in reducing the heart rate at rest and during exercise in patients with atrial fibrillation.
How do you reverse atrial fibrillation naturally?
Natural and Alternative Treatments for AFibAvoid stimulants.Get your nutrients.Stay hydrated.Supplements.Cut out gluten.Exercise and stress relief.Q&A.
What is the safest blood thinner for AFib?
For years, warfarin (Coumadin) was the only oral blood thinner available for preventing strokes caused by AFib, but newer medications called direct oral anticoagulants (DOACs) may be a better choice. In most people with AFib, the DOACs are the first-choice medication.
Does sotalol stop AFib?
About sotalol Sotalol belongs to a group of medicines called beta blockers. It’s used to treat atrial fibrillation and other conditions that cause an irregular heartbeat (arrhythmia). This medicine is only available on prescription.
Can you switch from a beta blocker to an ACE inhibitor?
Switching from beta blockers to ACE inhibitors Other BP medications are better suited for those patients.” Some studies suggest that switching from beta blockers to ACE inhibitors can help reduce symptoms of drowsiness and improve cognition.
What is equivalent to metoprolol?
Some metoprolol alternatives include Toprol XL, Coreg, Ernesto, Zestril, and Calan.
Is carvedilol better than metoprolol?
Based on the results of the COMET trial, the authors concluded that carvedilol, at a dose of 25 mg twice daily, provides superior morbidity and mortality benefit compared to metoprolol tartrate at a dose of 50 mg twice daily.
What type of beta-blocker is sotalol?
Sotalol is a non-cardioselective beta-blocker that also possesses potassium channel blocker properties. It classifies as a class III agent in the Vaughan-Williams classification system for antiarrhythmic medications due to its predominant potassium channel blocking effect.
What is safest beta-blocker?
A number of beta blockers, including atenolol (Tenormin) and metoprolol (Toprol, Lopressor), were designed to block only beta-1 receptors in heart cells. Since they don’t affect beta-2 receptors in blood vessels and the lungs, cardioselective beta blockers are safer for people with lung disorders.
Does sotalol help with anxiety?
A number of clinical trials have shown the effectiveness of beta-blockers such as propranolol, sotalol and oxprenolol, in the relief of anxiety symptoms both in comparison to placebo and benzodiazepines.
What is the difference between bisoprolol and sotalol?
Bisoprolol is a beta1-selective agent. In a recently pub- lished study, bisoprolol significantly reduced ventricu- lar, as well as supraventricular arrhythmias in patients with heart failure. On the other hand, sotalol possesses class-III effects in combination with beta-blockade.
How much sotalol is equivalent to 80 mg?
There is a dosage conversion between oral and intravenous sotalol. Oral sotalol 80 mg is equivalent to 75 mg of IV, and similarly, 160mg oral is equivalent to 150 mg of IV. If infusing intravenously, the recommendation is to administer the drug slowly as a rapid infusion can cause hypotension. 
What is the role of a pharmacist in sotalol?
A cardiology board-certified pharmacist can assist the clinician team with sotalol dosing and monitoring. Nursing will need to understand the signs of adverse events associated with the use of this drug and report the therapeutic effectiveness of the regimen to the team to enable therapy modifications if necessary. An interprofessional team approach to sotalol use allows for optimal outcomes while minimizing adverse effects. [Level 5]
How long does sotalol last in pregnancy?
Its half-life is 10 to 20 hours in a population with normal renal function. . However, its half-life decreases to 10 hours in pregnancy due to the increased glomerular filtration rate during pregnancy. Data show that sotalol should be avoided in pregnancy and during lactation.
What is the best treatment for fetal SVT?
Transplacental isolated sotalol or in conjunction with digoxin to treat fetal SVT and atrial fibrillation with 85% complete or partial resolution. 
How long after starting sotalol can you be in a hospital?
Most cardiologists recommend observing the patient in a hospital for at least three days after starting sotalol with serial EKGs. Toxicity. Sotalol toxicity is inherent due to its mechanisms of action as both a potassium channel blocker and a non-cardioselective beta-blocker and mirrors its adverse effect profile.
What are the side effects of beta blockade?
Other adverse effects associated with its non-cardioselective beta-blockade include bradycardia, fatigue, dyspnea, and worsening heart failure.
Is sotalol FDA approved?
Sotalol has the following are the FDA and non-FDA indications: premature ventricular contractions, hemodynamically stable ventricular tachycardia, pharmacological cardioversion of atrial fibrillation, maintaining sinus rhythm, postoperative atrial fibrillation after cardiac surgery, supraventricular tachycardia, and others. This activity outlines the indications, mechanisms of action, methods of administration, significant adverse effects, contraindications, and monitoring, of sotalol, so providers can direct patient therapy in treating indicated disorders as part of the interprofessional team, with a basis on the current knowledge for optimal utilization.
What are the effects of sotalol?
Rhythm control: Sotalol is an antiarrhythmic medication to treat certain types of heart rhythm disorders. Paradoxically it can cause potentially lethal cardiac rhyt… Read More
How is sotalol used; does the patient have to keep checking his levels?
Follow inscructions: First and foremost, follow your prescribing doc’s instructions…Sometimes doc will start you on a higher dosing, then taper down. Unlike ammiodarone… Read More
What is betapace (sotalol)?
Heart rhythm problem: Betapace ( sotalol) is used to control abnormal heart rhythms. Do you know what kind of rhythm problem she might have?
Is sotalol a heart medication?
Rhythm control: Sotalol is an antiarrhythmic medication to treat certain types of heart rhythm disorders. Paradoxically it can cause potentially lethal cardiac rhyt… Read More
Is it safe to take beta blockers while breastfeeding?
Beta blockers: This beta blocker is extensively found in the breast milk. It is not safe to be taken while breastfeeding. There are several beta blockers which are s… Read More
Can you take a negative intotrope for HOCM?
Yes : Any negative intotrope is fine for treatment of HOCM; beta blockers preferred to calcium channel blockers however because of additional cardio protect… Read More
Is sotolol good for atrial fibrillation?
See cardiology: Sotolol is typically used for atrial fibrillation. If these symptoms are signs of drug intolerance, another option might be considered, but such opti… Read More
What is the purpose of sotalol hydrochloride?
Sotalol hydrochloride/Sotalol hydrochloride AF tablets are indicated for the maintenance of normal sinus rhythm (delay in time to recurrence of AFIB/AFL) in patients with symptomatic AFIB/AFL who are currently in sinus rhythm.
What is the purpose of oral sotalol?
To minimize the risk of drug-induced arrhythmia, initiate or reinitiate oral Sotalol in a facility that can provide cardiac resuscitation and continuous electrocardiographic monitoring.
How long does it take for sotalol to be absorbed?
Absorption. In healthy subjects, the oral bioavailability of Sotalol is 90 to 100%. After oral administration, peak plasma concentrations are reached in 2.5 to 4 hours, and steady-state plasma concentrations are attained within 2 to 3 days (that is, after 5 to 6 doses when administered twice daily).
How long to stop sotalol hydrochloride?
When discontinuing chronically administered Sotalol hydrochloride/Sotalol hydrochloride AF, particularly in patients with ischemic heart disease, gradually reduce the dosage over a period of 1–2 weeks, if possible, and monitor the patient. If angina markedly worsens or acute coronary ischemia develops, treat appropriately (consider use of an alternative beta blocker). Warn patients not to interrupt therapy without their physician’s advice. Because coronary artery disease may be common, but unrecognized, in patients treated with Sotalol, abrupt discontinuation may unmask latent coronary insufficiency.
What are the symptoms of overdose of sotalol?
The most common signs to be expected are bradycardia, congestive heart failure, hypotension, bronchospasm and hypoglycemia. In cases of massive intentional over dosage (2 to 16 grams) of Sotalol the following clinical findings were seen: hypotension, bradycardia, cardiac asystole, prolongation of QT interval, Torsade de Pointes, ventricular tachycardia, and premature ventricular complexes. If over dosage occurs, therapy with Sotalol should be discontinued and the patient observed closely. Because of the lack of protein binding, hemodialysis is useful for reducing Sotalol plasma concentrations. Patients should be carefully observed until QT intervals are normalized and the heart rate returns to levels >50 bpm.
How many doses of sotalol should be taken after dialysis?
Dose escalations in renal impairment should be done after administration of at least 5 doses at appropriate intervals (Table 1). Sotalol is partly removed by dialysis; specific advice is unavailable on dosing patients on dialysis.
What are the adverse reactions to sotalol?
Adverse reactions that are clearly related to Sotalol are those which are typical of its Class II (beta-blocking) and Class III (cardiac action potential duration prolongation) effects and are dose related. Ventricular Arrhythmias.
Does sotalol cause sleep disorders?
According to the manufacturer, sleep disorders (of any kind) occur in 1 to 8 percent of sotalol users. However, a brief search on various bulletin boards online shows that, anecdotally at least, many people report vivid, strange dreams that started when they began the sotalol.
Is sotalol good for atrial fibrillation?
Sotalol is used to get and keep people out of atrial fibrillation. All the drugs that can do this successfully have the potential for side effects, and although amiodarone, a commonly used medicine for this purpose, is well-tolerated by most, every time I write a column on it, I get letters from people sharing their stories of side effects when taking it, sometimes severe.
What is the BSA of sotalol?
In children, a Class III electrophysiological effect can be seen at daily doses of 210 mg/m2 body surface area (BSA). A reduction of the resting heart rate due to the beta-blocking effect of sotalol is observed at daily doses >/=90 mg/m2 in children.
How much intratracheal should I give for Bradycardia?
Bradycardia: 0.5 mg I.V every 5 minutes, not to exceed a total of 3 mg or 0.04 mg/kg; may give intratracheal in 1 mg/10 ml dilution only, intratracheal dose should be 2-2.5 times the I.V. dose. (Doses <0.5 mg have been associated with paradoxical bradycardia.)
How long to infuse Cordarone I.V.?
Cordarone I.V. concentrations greater than 3 mg/ml in D 5 W have been associated with a high incidence of peripheral vein phlebitis; however, concentrations of 2.5 mg/ml or less appear to be less irritating. Therefore, for infusions longer than 1 hour, Cordarone I.V. concentrations should not exceed 2 mg/ml unless a central venous catheter is used. Cordarone I.V. infusions exceeding 2 hours must be administered in glass or polyolefin bottles containing D5W. Use of evacuated glass containers for admixing Cordarone I.V. is not recommended as incompatibility with a buffer in the container may cause precipitation.
How long to infuse a bolus?
Reconstitution: Dissolve each vial with 4 ml sterile water (do not shake). May be further diluted with normal saline. Infuse over 30 minutes– must use 0.22 micron filter. If cardiac arrest is imminent, may give as a bolus.
Is mullaq contraindicated for heart failure?
MULTAQ is contraindicated in patients with NYHA Class IV heart failure, or NYHA Class II – III heart failure with a recent decompensation requiring hospitalization or referral to a specialized heart failure clinic [see Contraindications].
Does sotalol block beta adrenoreceptors?
Mechanism of Action: Sotalol has both beta-adrenoreceptor blocking (Vaughan Williams Class II) and cardiac action potential duration prolongation (Vaughan Williams Class III) antiarrhythmic properties. Sotalol hydrochloride is a racemic mixture of two isomers, both of which have similar Class III antiarrhythmic effects, while the l-isomer is responsible for virtually all of the beta-blocking activity. The beta-blocking effect of sotalol is non-cardioselective, half maximal at an oral dose of about 80 mg/day and maximal at doses between 320 and 640 mg/day. Sotalol does not have partial agonist or membrane stabilizing activity. Although significant beta-blockade occurs at oral doses as low as 25 mg, significant Class III effects are seen only at daily doses of 160 mg and above.
Why are generic drugs cheaper than brand names?
Generic drugs are cheaper than brand name drugs because the manufacturer does not have to spend money to discover and test the drug. Although generic drugs are chemically identical to their branded counterparts, they are typically sold at substantial discounts from the branded price.
What is the difference between generic and brand name drugs?
A brand name drug in the U.S. is approved by the Food and Drug Administration (FDA), and is supplied by one company – the pharmaceutical manufacturer. The drug is protected by a patent and is marketed under the manufacturer’s brand name. Whereas a generic medication, also approved by the FDA, is basically a copy of the brand name drug …
What Are Generic Drugs?
Generic drugs are copies of brand-name drugs and are the same as those brand name drugs in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use. All generic drugs approved by FDA have the same high quality, strength, purity and stability as brand-name drugs. And, the generic manufacturing, packaging, and testing sites must pass the same quality standards as those of brand name drugs. Approximately half of all brand name drugs on the market have generic versions.
How much money did generic drugs save in 2010?
Generic Drug Facts and Statistics. In 2010 the use of FDA approved generics saved $158 billion, an average of $3 billion every week. The U.S. FDA requires generic drugs have the same high quality, strength, purity and stability as brand-name drugs.
Do generic drugs have the same quality as brand names?
And, the generic manufacturing, packaging, and testing sites must pass the same quality standards as those of brand name drugs. Approximately half of all brand name drugs on the market have generic versions.
Can a generic drug look the same as a brand name?
There are laws in the United States that say that a generic version of a drug cannot look the same as a brand name version. Just because two versions of the drug do not look the same does not mean they act differently in the body.
Can a pharmacist substitute a generic for a brand name?
However, if your doctor specifies that a brand name must be dispensed, then the pharmacist may not substitute the generic. Sometimes an acceptable generic is available that your doctor may not be aware of.
Indications and Usage For Sotalol
- Life-Threatening Ventricular Arrhythmias
Sotalol hydrochloride/Sotalol hydrochloride AF tablets are indicated for the treatment of documented, life-threatening, ventricular arrhythmias, such as sustained ventricular tachycardia (VT). Limitation of Use: Sotalol hydrochloride/Sotalol hydrochloride AF has not been shown to e…
- Delay in Recurrence of Atrial Fibrillation/Atrial Flutter
Sotalol hydrochloride/Sotalol hydrochloride AF tablets are indicated for the maintenance of normal sinus rhythm (delay in time to recurrence of AFIB/AFL) in patients with highly symptomatic AFIB/AFL who are currently in sinus rhythm. Limitation of Use: Because Sotalol hydrochloride/So…
Sotalol Dosage and Administration
- General Safety Measures for Initiation of Oral Sotalol Therapy
Withdraw other antiarrhythmic therapy before starting Sotalol hydrochloride/Sotalol hydrochloride AF tablets and monitor for a minimum of 2 to 3 plasma half-lives prior to initiating Sotalol hydrochloride/Sotalol hydrochloride AF tablets therapy if the patient’s clinical condition permits […
- Adult Dose for Ventricular Arrhythmias
The recommended initial dose is 80 mg twice daily. This dose may be increased in increments of 80 mg per day every 3 days provided the QTc <500 msec [see Warnings and Precautions (5.1)].Continually monitor patients until steady state blood levels are achieved. In most patients, …
Dosage Forms and Strengths
Sotalol Hydrochloride Tablets, USP are available as following: 1. 1. 80 mg tablets: white to off-white capsule shaped, scored tablets, imprinted “APO” on one side and “SO” bisect “80” on the other side. 2. 1. 120 mg tablets: white to off-white capsule shaped, scored tablets, imprinted “APO” on one side and “SOT” bisect “120” on the other side. 3. 1. 160 mg tablets: white to off-whi…
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Warnings and Precautions
- QT Prolongation and Proarrhythmia
Sotalol hydrochloride/Sotalol hydrochloride AF can cause serious and potentially fatal ventricular arrhythmias such as sustained VT/VF, primarily Torsade de Pointes (TdP) type ventricular tachycardia, a polymorphic ventricular tachycardia associated with QT interval prolongation. Fac…
- Bradycardia/Heart Block/Sick Sinus Syndrome
Sinus bradycardia (heart rate less than 50 bpm) occurred in 13% of patients receiving Sotalol in clinical trials, and led to discontinuation in about 3% of patients. Bradycardia itself increases the risk of Torsade de Pointes. Sinus pause, sinus arrest and sinus node dysfunction occur in less th…
- Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Adverse reactions that are clear…
- Postmarketing Experience
The following adverse drug reactions have been identified during post-approval use of Sotalol. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug ex…
- Antiarrhythmics and other QT Prolonging Drugs
Discontinue Class I or Class III antiarrhythmic agents for at least three half-lives prior to dosing with Sotalol. Class Ia antiarrhythmic drugs, such as disopyramide, quinidine and procainamide, and other Class III drugs (for example, amiodarone) are not recommended as concomitant thera…
- Negative Chronotropes
Digitalis glycosides, diltiazem, verapamil, and beta-blockers slow atrioventricular conduction and decrease heart rate. Concomitant use with negative chronotropes can increase the risk of bradycardia or hypotension.
Use in Specific Populations
Risk Summary Both the untreated underlying condition in pregnancy and the use of Sotalol in pregnancy cause adverse outcomes to the mother and fetus/neonate (see Clinical Considerations). In animal reproduction studies in rats, early resorptions were increased at 15 ti…
Risk Summary Limited available data from published literature report that Sotalol is present in human milk. The estimated daily infant dose of Sotalol received from breastmilk is 0.8-3.4 mg/kg, estimated at 22 to 25.5% of the maternal weight-adjusted dosage of Sotalol hydrochloride (see …
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Sotalol hydrochloride/Sotalol hydrochloride AF tablets, USP contains Sotalol hydrochloride, an antiarrhythmic drug with Class II (beta‑-adrenoreceptor blocking) and Class III (cardiac action potential duration prolongation) properties. Sotalol hydrochloride tablets, USP are supplied as a white to off-white, capsule-shaped, scored tablet for oral administration. Sotalol hydrochloride A…