Sotalol: Price, Dosage & Where to Buy

Sotalol is an antiarrhythmic medicine with beta-blocking effects, used to help maintain a normal heart rhythm in people with highly symptomatic atrial fibrillation or atrial flutter. It helps delay the return of these rhythm problems once a normal rhythm has been restored. Sotalol requires a prescription in the United Kingdom, and starting or restarting treatment needs close heart monitoring.

Sotalol affects the electrical signals that control the heartbeat. Its beta-blocking action reduces the effect of stress signals on the heart, which can slow the heart rate and the passage of electrical signals. It also lengthens the time heart cells need to recover before responding to another electrical signal.

This can help prevent abnormal rhythms from returning. However, extending this recovery time too much can cause a different, serious rhythm problem. Heart tracing checks help clinicians monitor this effect during treatment.

Sotalol is used to maintain a normal heart rhythm in people with atrial fibrillation or atrial flutter who are currently in normal rhythm. These conditions affect the rhythm of the heart's upper chambers. Its use is reserved for people whose symptoms are substantial, because the medicine itself can cause serious rhythm problems.

The label advises avoiding it when these conditions cause minimal symptoms or are easily reversed. Sotalol is also used for documented, life-threatening rhythm problems arising in the heart's lower chambers, such as sustained ventricular tachycardia. It has not been shown to improve survival in people with these life-threatening ventricular rhythm problems.

The label lists oral tablets in strengths of 80 mg, 120 mg, 160 mg and 240 mg. The label lists an oral solution of 5 mg/mL and an intravenous injection of 15 mg/mL. The usual starting dose is 80 mg twice daily for adults with ventricular arrhythmias or for preventing recurrence of atrial fibrillation or flutter.

The label lists increases of 80 mg per day every 3 days, subject to heart tracing results, up to a maximum total daily dose of 320 mg. The label lists 120 mg twice daily as producing a satisfactory response in most patients treated for atrial fibrillation or flutter. Starting or restarting oral treatment requires a facility with continuous heart tracing monitoring and cardiac resuscitation facilities.

Kidney function determines the appropriate interval between doses. Blood potassium and magnesium levels are checked and corrected before treatment begins. Children's dosing depends on age and requires the same safety precautions as adult treatment.

The label states that tablets should be stored at 20°C to 25°C, with excursions permitted from 15°C to 30°C. Do not use tablets if the blister is torn or broken. Keep medicines out of children's reach.

For a missed dose, the label advises that the next dose remains at its usual scheduled time. A missed dose should not be made up by doubling the dose or shortening the interval. If treatment has been interrupted, contact the prescriber, because restarting sotalol requires monitored care.

Both untreated heart rhythm problems and sotalol use during pregnancy can cause harm to the mother and baby. Sotalol crosses the placenta. Reported potential effects include restricted growth, a slow fetal heartbeat, low blood sugar and serious fetal rhythm problems, including possible death before birth.

Continuous monitoring is advised during labour and delivery, and the newborn should be monitored for beta-blocking effects. Sotalol is present in breast milk at high levels.

The label advises against breastfeeding during treatment because of potentially serious effects on the breastfed child. Pregnancy or breastfeeding plans should be discussed with the prescriber.