Sotalol (Betapace, Sotahexal)
Mechanism of action
Antiarrhythmic (Class III)
Inhibits rapid potassium channels (class III AA) as well as beta-1 adrenergic receptors (class II AA) in the myocardial cells. These actions slow down repolarization and prolong QT interval, duration of action potentials and refractory period which leads to decrease of heart rate as a result.
Indications and dose
Pharmacokinetics
Onset of action:
- Peak levels: 2.5–4 hours
- Steady-state: 2–3 day
Half-life of elimination: 10–20 hours
Metabolism: Not metabolized
Elimination: Kidneys (up to 90 % of unchanged drug), liver
Directions for administration
Since first administration of sotalol is often associated with dizziness, it’s recommended to administer the first dose at bedtime.
Adjust dose for renally impaired patients since sotalol is excreted mainly in urine.
Medicinal forms
Pills – 40 mg, 80 mg, 160 mg
Side-effects
QT prolongation !!!
Arrhythmia (torsades de pointes)
Dizziness
Headache
Dyspnoea
Fatigue
Excessive bradycardia
Hypotension
References
