Sotalol

Sotalol can be taken with or without food, but it is best to do the same each day.

Swallow the tablets whole with a drink of water.

Sotalol can be taken by adults and children over the age of 12 years. It can also be taken by children under the age of 12 on the advice of their specialist. However, it is not suitable for everyone.

To make sure it is safe, before starting the medication, the doctor should be made aware of:[1]

• any allergic reaction to sotalol or any other medicine
• low blood pressure or a slow heart rate
• heart failure which is getting worse, heart disease, or a recent heart attack
• any problems with the kidneys
• an overactive thyroid (hyperthyroidism) – sotalol may make it more difficult to recognise the warning signs of having too much thyroid hormone in the body (thyrotoxicosis)
• severe blood circulation problems in the limbs (such as Raynaud's phenomenon), which may make the fingers and toes tingle or turn pale or blue (this may be less noticeable on black or brown skin)
• metabolic acidosis – when there is too much acid in the blood
• a lung disease or severe asthma
• severe diarrhoea

This medicine is only available on prescription. It comes as tablets. Take sotalol exactly as the doctor has instructed, and follow the instructions on the label. If unsure, check with the doctor or pharmacist.

Important: Take sotalol even if you feel well, as you will still be getting the benefits of the medicine.

Usually, sotalol is taken once or twice a day. If sotalol is being taken twice a day, it is best to try and take it in the morning and in the evening.

The doctor may advise that the first dose is taken before bedtime, because it can make some people feel dizzy. After the first dose, if it does not cause dizzy feelings, it can be taken in the morning.

Sotalol tablets come in different strengths: 40mg, 80mg and 160mg.[1]

The usual dose of sotalol is between 80mg and 320mg a day. If irregular heartbeats are still happening several times a day, the doctor may prescribe a higher daily dose of up to 640mg.[1]

In those who are older or have kidney problems, the doctor may prescribe a lower dose.[1]

If a dose is missed, then take it as soon as it is remembered, unless it's nearly time for the next dose. In this case, just leave out the missed dose and take the next dose at the usual time. Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.[1]

If doses taking the medicine is often forgot, it may help to set an alarm as a reminder. Also, ask a pharmacist for advice on other ways to help remember to take medicines.[1]

Taking too much sotalol can slow down the heart rate and make it difficult to breathe. It can also cause dizziness and trembling.[1]

The amount of sotalol that can lead to an overdose varies from person to person[1]. Call the doctor or non-emergency services.[1]

If needing to go to A&E, do not drive. Get someone else to drive or call an ambulance. Take the sotalol packet, or the leaflet inside the packet, plus any remaining medicine too.[1]

More than the prescribed dose of sotalol has been taken and symptoms appear, such as:[1]

• the heart rate (pulse) has slowed down
• there is difficulty breathing, is wheezing and tightening of the chest – these can be signs of lung problems
• shortness of breath with a cough which gets worse with exercise (like walking upstairs), swollen ankles or legs, chest pain, or an irregular heartbeat – if these occur it is a sign of heart problems

These common side effects happen in more than 1 in 100 people. They're usually mild and short-lived.[1]

Talk to the doctor or pharmacist if the side effects last more than a few days or are affecting life in a big way:[1]

• headaches
• feeling tired, dizzy or weak
• cold fingers or toes
• diarrhoea, feeling or being sick (nausea or vomiting)
• stomach pain

It happens rarely, but some people have serious side effects when taking sotalol.[1] Watch out for, and call non-emergency or call a/the doctor now if:[1]

• the whites of the eyes turn yellow, the skin turns yellow (although this may be less obvious on brown or black skin), or poo is pale or dark pee. These can be signs of liver problems
• nosebleeds that last for more than 10 minutes, unexplained bruising, or bruising more easily than usual. These can be signs of low numbers of platelets in the blood (thrombocytopenia)

In rare cases, sotalol may cause a serious allergic reaction (anaphylaxis).

If a doctor or health visitor says that baby is healthy, then it is OK to take sotalol while breastfeeding. Sotalol can pass into breast milk in quite high amounts, but studies looking at sotalol have not shown any side effects in breastfed babies. Other beta blockers have been linked with side effects in breastfed babies.[1]

It's important to keep taking sotalol to keep the mother well. Breastfeeding will also benefit both mother and baby.[1]

If it is noticed that baby is not feeding as well as usual, or seems unusually sleepy, seems much paler than usual, or if there are any other concerns about baby, talk to the health visitor, midwife or doctor as soon as possible. They may recommend a different medicine to take.[1]

Tell a doctor if trying for a baby, already pregnant, or breastfeeding while taking this medicine.

There's very little information about taking herbal remedies and supplements with sotalol. Tell the doctor or pharmacist if taking any other medicines, including herbal medicines, vitamins or supplements.[1]