Class III / Non-selective Beta Blocker·Cardiovascular - Antiarrhythmics

Sotalol

Maintenance of sinus rhythm in AF/AFL, suppression of VT

PBSCLASS IIISotacor, Solavert80 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

320 mg/day

Half-life

10–20 h

High risk: QTc Risk

HIGH

Caution: Renal Adj.

MANDATORY

Cautions

Avoid / Cautions

Severe asthma, baseline QTc > 450 ms, uncorrected hypokalemia, 2nd/3rd degree heart block, severe renal failure. Pregnancy Category C.

Where it stands

Rapid Summary

Overview

Unique agent combining potent non-selective beta-blockade (Class II) with potassium channel blockade (Class III). Used for strict rhythm control in arrhythmias.

Clinical Focus

High risk of QT prolongation and Torsades de Pointes. Excreted 100% via kidneys; lethal if unadjusted in renal failure.

Bottom Line

Sotalol is a unique combined beta-blocker and Class III antiarrhythmic for AF and VT, but prolongs QTc and requires ECG monitoring with dose changes due to risk of Torsades de Pointes.

Formulation & Access

Brand Names

Sotacor, Solavert

Oral Routes

Tablets (80 mg, 160 mg).

Parenteral

Ampoule for IV use (Rare, highly specialised).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Maintenance of sinus rhythm in AF/AFL, suppression of VT.

Clinical Place

Used when a patient needs both rate and rhythm control, but requires perfect renal function and QT monitoring.

Quick reference

Class & Role

Class III / Non-selective Beta Blocker — Unique agent combining potent non-selective beta-blockade (Class II) with potassium channel blockade (Class III).

Route / Formulation

Tablets (80 mg, 160 mg). (Sotacor, Solavert)

Usual Dose & Max

Start PO 80 mg BD. Titrate slowly under ECG guidance to Max 160 mg BD (320 mg/day).

Key Indication Doses

AF Rhythm Control: Start PO 80 mg BD. Titrate slowly under ECG guidance to Max 160 mg BD (320 mg/day). Ventricular Arrhythmias: PO 80-160 mg BD. Renal Impairment: eGFR 30-60: Give dose OD. eGFR 10-30: Give dose every 48 hours. eGFR <10: CONTRAINDICATED.

Best Uses

Sotalol is a unique combined beta-blocker and Class III antiarrhythmic for AF and VT, but prolongs QTc and requires ECG monitoring with dose changes due to risk of Torsades de Pointes.

Key Risks

Cardiovascular: Dose-dependent QTc prolongation, Torsades de Pointes, profound bradycardia, heart failure exacerbation. Respiratory: Bronchospasm (non-selective beta blocker). Neurological: Fatigue, dizziness, sleep disturbances.

Key Interactions

Any other QT prolonging drugs (e.g., Macrolides, SSRIs, Antipsychotics) risk fatal arrhythmias. Non-DHP CCBs (Verapamil) risk asystole.

Monitoring

Baseline and ongoing ECG. Cease immediately if QTc > 500 ms. Do not start until baseline QTc is confirmed normal. Strict baseline and regular U&E (K+ and Mg2+ MUST be kept in the high-normal range) and eGFR.

Clinical Pearl

Sotalol has a dangerous paradox: its QT-prolonging effect is strongest when the heart rate is SLOW. This makes bradycardic patients exquisitely vulnerable to Torsades de Pointes.

Access

Sotacor, Solavert80 mg tablet

Brand: Sotacor, Solavert
Formulation: Tablets (80 mg, 160 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Class III / Non-selective Beta Blocker·Cardiovascular - Antiarrhythmics

Sotalol

Maintenance of sinus rhythm in AF/AFL, suppression of VT

PBSCLASS IIISotacor, Solavert80 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

320 mg/day

Half-life

10–20 h

High risk: QTc Risk

HIGH

Caution: Renal Adj.

MANDATORY

Cautions

Avoid / Cautions

Severe asthma, baseline QTc > 450 ms, uncorrected hypokalemia, 2nd/3rd degree heart block, severe renal failure. Pregnancy Category C.

Where it stands

Rapid Summary

Overview

Unique agent combining potent non-selective beta-blockade (Class II) with potassium channel blockade (Class III). Used for strict rhythm control in arrhythmias.

Clinical Focus

High risk of QT prolongation and Torsades de Pointes. Excreted 100% via kidneys; lethal if unadjusted in renal failure.

Bottom Line

Sotalol is a unique combined beta-blocker and Class III antiarrhythmic for AF and VT, but prolongs QTc and requires ECG monitoring with dose changes due to risk of Torsades de Pointes.

Formulation & Access

Brand Names

Sotacor, Solavert

Oral Routes

Tablets (80 mg, 160 mg).

Parenteral

Ampoule for IV use (Rare, highly specialised).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Maintenance of sinus rhythm in AF/AFL, suppression of VT.

Clinical Place

Used when a patient needs both rate and rhythm control, but requires perfect renal function and QT monitoring.

Quick reference

Class & Role

Class III / Non-selective Beta Blocker — Unique agent combining potent non-selective beta-blockade (Class II) with potassium channel blockade (Class III).

Route / Formulation

Tablets (80 mg, 160 mg). (Sotacor, Solavert)

Usual Dose & Max

Start PO 80 mg BD. Titrate slowly under ECG guidance to Max 160 mg BD (320 mg/day).

Key Indication Doses

Best Uses

Sotalol is a unique combined beta-blocker and Class III antiarrhythmic for AF and VT, but prolongs QTc and requires ECG monitoring with dose changes due to risk of Torsades de Pointes.

Key Risks

Key Interactions

Any other QT prolonging drugs (e.g., Macrolides, SSRIs, Antipsychotics) risk fatal arrhythmias. Non-DHP CCBs (Verapamil) risk asystole.

Monitoring

Clinical Pearl

Sotalol has a dangerous paradox: its QT-prolonging effect is strongest when the heart rate is SLOW. This makes bradycardic patients exquisitely vulnerable to Torsades de Pointes.

Access

Sotacor, Solavert80 mg tablet

Brand: Sotacor, Solavert
Formulation: Tablets (80 mg, 160 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.