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Uses

What is sotalol used for?

Sotalol is commonly used for the following conditions.

Sotalol may also be used for other conditions as determined by your healthcare provider.

How does sotalol work (mechanism of action)?

Having an irregular or fast heartbeat can be dangerous. Sotalol works by slowing down your heart and blocking certain electrical signals in your heart that can cause it to beat too fast or in an irregular way. This helps keep your heart rhythm normal.

How is sotalol supplied (dosage forms)?

Brands and other names

  • Betapace
  • Betapace AF
  • Sorine
  • Sotylize

Dosage forms and strengths

  • 5 mg/mL oral solution
  • 80 mg, 120 mg, 160 mg, 240 mg oral tablets

How should I store sotalol?

Sotalol should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. 

Side Effects

What are the most common side effects of sotalol?

The most common side effects of sotalol are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Feeling unusually weak or tired
  • Shortness of breath
  • Dizziness
  • Heart rhythm changes (see below)
  • Heart rate changes (see below)

There may be other side effects of sotalol that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of sotalol?

While less common, the most serious side effects of sotalol are described below, along with what to do if they happen.

Heart Rhythm Changes. Sotalol may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Heart Rate Changes. Sotalol can make your heart beat slower than normal (bradycardia). Call your healthcare provider right away if you have any of the following symptoms of bradycardia.

  • Feeling lightheaded, dizziness, or fainting
  • Confusion
  • Feeling weak or easily tired
  • Chest pain
  • Shortness of breath

Low Blood Pressure (Hypotension). Sotalol may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.

  • Dizziness, feeling lightheaded, or fainting
  • Confusion
  • Feeling weak or tired

New or Worsening Heart Failure. Sotalol may worsen existing heart failure or cause fluid buildup in your body. For individuals with underlying heart disease or heart damage, sotalol can potentially lead to heart failure over time. Tell your healthcare provider right away if you have any of the following symptoms of heart failure.

  • Shortness of breath or trouble breathing, especially while lying down
  • Swelling in your feet, ankles, or legs
  • Unusually fast weight gain
  • Unusual tiredness

Severe Allergic Reactions. Sotalol may cause allergic reactions, which can be serious. Stop taking sotalol and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use sotalol?

Allergies to Ingredients. People who are allergic to any of the following should not take sotalol.

  • Betapace
  • Betapace AF
  • Sorine
  • Sotylize
  • Sotalol
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific sotalol products they stock.

Bradycardia. Sotalol should not be used if your heart is beating too slowly (bradycardia).

Heart Problems. Sotalol should not be taken if you have second or third degree heart block or sinus sick syndrome, unless you have a pacemaker. 

Asthma. Sotalol should not be used by those with asthma or similar breathing problems.

Severe or Worsening Heart Failure. Sotalol should not be used if your heart failure is severe or getting worse, causing you to feel very tired, have trouble breathing, or swelling in your legs. 

Cardiogenic Shock. Sotalol should not be used if you have a life-threatening condition called cardiogenic shock where your heart cannot pump enough blood to the rest of your body.

Low Potassium Levels (Hypokalemia). Sotalol should not be used if you have low levels of potassium. Your healthcare provider may check your potassium levels before starting this medicine. 

Long QT Interval. Sotalol should not be used by those with long QT syndrome, a condition that causes an irregular heart rhythm. Sotalol should also not be used if part of your heartbeat, the QT interval, takes too long to complete. Your doctor may monitor your heart rate and rhythm before starting this medicine.

What should I know about sotalol before using it?

Do not take sotalol unless it has been prescribed to you by a healthcare provider. Take it as prescribed. 

Try not to miss any doses of this medicine. You may want to set an alarm to help remind you to take each dose on time.

Sotalol is usually started in a hospital so your healthcare provider can monitor your heart rate and rhythm for the first few days to make sure the medicine is safe and working well. 

Do not share sotalol with other people, even if they have the same condition as you. It may harm them.

Sotalol can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how sotalol affects you.

Stopping sotalol suddenly may lead to chest pain or heart attack in people with heart disease. Do not stop taking this medication without talking to your healthcare provider first. 

Keep sotalol out of the reach of children.

If using the oral solution, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.

What should I tell my healthcare provider before using sotalol?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if sotalol is right for you.

In particular, make sure that you discuss any of the following.

Other Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Heart disease, including heart failure
  • Irregular heart rate or rhythm
  • Breathing problems
  • Kidney problems
  • Thyroid problems
  • Low blood pressure
  • Electrolyte imbalance, such as low levels of potassium or magnesium
  • Persistent or severe vomiting or diarrhea

Diabetes. Sotalol can decrease early signs of low blood sugar, such as fast heartbeat, and make it more likely for the low blood sugar to be serious, especially for people with diabetes.

Other Medicines and Supplements. Sotalol may interact with other medicines and supplements. Before taking sotalol, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how sotalol could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take sotalol while you are pregnant or trying to get pregnant.

Breastfeeding. Do not take sotalol while you are breastfeeding. Sotalol can pass into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. 

Interactions

Does sotalol interact with foods or drinks?

There are no known interactions between sotalol and foods or drinks.

It is unknown if drinking alcohol will affect sotalol. The risk of dizziness may be increased if you drink alcohol while taking sotalol.

Does sotalol interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking sotalol

  • Medicines within the past 2 weeks that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as disopyramide, quinidine, procainamide, or amiodarone
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • A beta-blocker, such as metoprolol (Lopressor, Toprol XL, and others), atenolol (Tenormin), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
  • Diltiazem (Cardizem CD and others) or verapamil (Verelan, Verelan PM), which is a medicine commonly used for high blood pressure and other conditions
  • Clonidine (Catapres-TTS and others), which is a medicine used for high blood pressure or attention deficit hyperactivity disorder (ADHD)
  • A beta-2 agonist, such as albuterol, arformoterol (Brovana), levalbuterol (Xopenex HFA), formoterol (Perforomist), olodaterol (Striverdi), or salmeterol (Serevent), which is a medicine commonly used for asthma or COPD
  • A medicine for diabetes 
  • Any medicine used to control your heart rate or rhythm (antiarrhythmic)
  • Antacids or supplements containing aluminum or magnesium

This may not be a complete list of medicines that can interact with sotalol. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much sotalol?

If you or someone else has used too much sotalol, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of sotalol?

Try not to miss any doses. If you miss a dose, skip the missed dose. Then, take your next dose when you normally would. Do not take double or extra doses.