Drug Classification & Information
Sotalol is classified as an anti-arrhythmic medication (class III with non-selective beta blocking effects). It is typically the first line of treatment of ventricular arrhythmias in veterinary species. Food may reduce bioavailability of the medication so may be best given on an empty stomach.
Indications for Use
Sotalol is indicated for the treatment of a variety of arrhythmias including ventricular and supraventricular arrhythmias. May be helpful in patients with supraventricular tachycardia secondary to an accessory pathway. May be used in patients with atrial fibrillation to slow the heart rate. May help to maintain sinus rhythm in a patient with previous atrial fibrillation.
Potential Drug Interactions
Should not be used in conjunction with amiodarone due to pro-arrhythmic effects. Antacids may reduce sotalol absorption (separate dosing by 1-2 hours). Use with azithromycin may increase risk for toxicity. Caution with some antibiotics (erythromycin, fluoroquinolones) as may increase risk for arrhythmias. Caution with digoxin due to concern for pro-arrhythmic effects.
Drug Side Effects
Side effects are generally related to the beta blocking effects of this medication. This may include lethargy, weakness, reduced appetite or a risk for collapse. Vomiting has been reported. Caution in patients with reduced heart contractility such as dilated cardiomyopathy. Caution in patients with active congestive heart failure (dose may need to be adjusted/lowered). May have the potential to worsen some arrhythmias (pro-arrhythmic effect). May cause bronchospasm so caution in patients with airway disease (asthma, bronchitis).
Electrocardiograms (ECGs) and Holter monitors indicated to follow treatment efficacy.
Human: 80, 120, 160 & 240 mg tablets