Sotalol

It is a non-selective b-adrenergic receptor blocker that also exhibits class III antiarrhythmic properties by its inhibition of potassium channels. Because of this dual action, sotalol prolongs both the PR interval and the QT interval.

Indications

Ventricular arrhythmiass such as polymorphic VT, maintenance of normal sinus rhythm in atrial fibrillation/atrial flutter.

Dosage

Oral; 160-480mg Dose should be escalated along with cardiac rhythm monitoring.

Contra-Indications

Bronchial asthma, sinus bradycardia, second and third degree AV block, unless a functioning pacemaker is present, congenital or acquired long QT syndromes, cardiogenic shock, uncontrolled congestive heart failure and Hypersensitivity.

Special Precautions

Paediatric: Safety not established Pregnancy: Category B; Use with caution. Lactation : Excreted in milk Elderly : Use with caution

Side Effects

Torsade de pointes and other serious new ventricular arrhythmias, fatigue, bradycardia, dyspnea, proarrhythmia, asthenia, dizziness, emotional lability, slightly clouded sensorium, incoordination, vertigo, paralysis, thrombocytopenia, eosinophilia, leukopenia, photosensitivity reaction, fever, pulmonary edema, hyperlipidemia, myalgia, pruritis, alopecia.

Drug Interactions

Antiarrhythmics, Digoxin, Calcium-blocking drugs, Catecholamine-depleting agents, insulin and oral antidiabetics, Beta-2-receptor stimulants, clonidine, antacids, drugs prolonging the QT interval.