Sotalol belongs to the classes of medications called antiarrhythmics and beta-blockers. It is used to treat certain types of abnormal heart rhythms (arrhythmias). It works by changing how electrical impulses affect the heart muscle and by helping the heart to beat more regularly.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended adult dose of sotalol ranges from 80 mg twice daily to 160 mg twice daily taken every 12 hours. Sotalol is best taken 1 to 2 hours before meals. The dose is usually started at the lower range and increased gradually according to your doctor's instructions until the best dose is determined.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take this medication if you:

• are allergic to sotalol or any ingredients of the medication
• have a severely slow heart rate
• have allergic rhinitis
• have asthma or severe chronic obstructive respiratory diseases (e.g., emphysema, chronic bronchitis)
• have long QT syndrome
• have low potassium levels in the blood
• have serious heart block (second- and third-degree AV block), unless a functioning pacemaker is present
• have severe or uncontrolled congestive heart failure
• have severe sinus node dysfunction
• have sick sinus syndrome

Do not give this medication to people in cardiogenic shock.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• anxiety
• decreased sexual ability
• diarrhea
• difficulty sleeping
• dizziness or lightheadedness
• headache
• heartburn
• increased sweating
• itching of skin
• loss of appetite
• muscle pain
• nausea or vomiting
• nervousness
• numbness or tingling of fingers or toes
• unusual tiredness or weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• back or joint pain
• breathing difficulty or wheezing
• fainting
• shortness of breath
• signs of heart failure (e.g., shortness of breath; fatigue; swelling in legs, ankles, feet)
• skin rash
• slow heartbeat (especially less than 50 beats per minute)
• symptoms of irregular heartbeat (e.g., chest pain; dizziness; rapid, pounding heartbeat; shortness of breath)
• symptoms of low blood pressure (e.g., fainting, dizziness, lightheadedness, blurred vision, nausea)
• vision changes or problems

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain
• fast or irregular heartbeat
• signs of a severe allergic reaction, e.g.:
• hives
• shortness of breath
• swelling of the lips, tongue, or throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Abnormal heart rhythm: Sotalol may cause a heart rhythm disturbance called QT prolongation. It can also worsen or trigger an irregular heart beat (arrhythmia). Your doctor will monitor your heart rhythm regularly while you are taking this medication with a test called an electrocardiogram (ECG).

Congestive heart failure: Sotalol can cause a decrease in the strength of your heartbeat. This can cause heart failure symptoms to occur or become worse. If you have congestive heart failure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Diabetes: The signs of low blood sugar may not be as noticeable when taking sotalol. If you have diabetes and take insulin or other medications that work by reducing blood sugar levels, you should monitor blood sugar carefully while taking this medication. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Electrolyte levels: People with low potassium or magnesium levels should not use sotalol until these imbalances are corrected, as these conditions can create higher risk for abnormal heart rhythms with the use of this medication.

Hyperthyroidism (high level of thyroid hormones): Sotalol may reduce the symptoms of hyperthyroidism, giving a false impression of improvement. Stopping the medication suddenly could worsen hyperthyroidism. If you have hyperthyroidism, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: Sotalol passes out of the body via the kidneys. Decreased kidney function or kidney disease can cause sotalol to build up in the body causing side effects. If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Lung problems: People with asthma and certain other lung problems (e.g., chronic bronchitis, emphysema) should not take sotalol.

Severe allergies: If you have allergies severe enough to cause anaphylaxis (a severe allergic reaction where swelling of the face, lips, and throat make it difficult to breathe), you should talk to your doctor about what to do if you have an allergic reaction. Sotalol may make it more difficult to treat your allergic reaction with epinephrine.

Stopping the medication: Stopping this medication suddenly can cause abnormal heart rhythms, chest pain (angina), and even heart attack. Do not suddenly stop taking this medication. Consult your doctor about how to safely stop taking this medication.

Surgery: Sotalol can interfere with how some medications that are used in surgery work. If you are scheduled for surgery, inform all doctors involved in your care that you are taking sotalol.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are breast-feeding and are taking sotalol, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children and adolescents: The safety and effectiveness of using sotalol have not been established for children and adolescents under 18 years of age.

There may be an interaction between sotalol and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.