Safety Information on Sotalol

Specific Sotalol Warnings and Precautions

Some precautions and warnings to be aware of prior to taking sotalol include the following:
  • Like other arrhythmia medications, sotalol may actually increase the risk of life-threatening arrhythmias. For this reason, it should be used only if absolutely necessary.
  • Your kidney function must be measured using a simple blood test before you start this medication. The kidneys remove sotalol from the body, and the starting dosage will be calculated based on your kidney function.
  • Once you begin taking this medication, your heart must be continuously monitored with an electrocardiogram (ECG) until three days after you have reached your steady sotalol dosage. This means you must stay in a hospital or other facility that is able to provide the ECG monitoring, measure your kidney function, and handle any emergencies that arise.
  • Low electrolytes may increase the risk of dangerous arrhythmias due to sotalol. Tell your healthcare provider if you have severe or prolonged diarrhea while taking this medicine, since such problems may cause low electrolytes.
  • As with all beta blockers, you should not abruptly stop taking sotalol, as serious problems (including heart attacks) may result. Your healthcare provider will advise you about how to safely stop taking this medication. People are typically advised to slowly reduce the dose over a period of one to two weeks, with careful monitoring. It is best to minimize physical activity during this time. Let your healthcare provider know if you develop chest pain or any other problems while stopping treatment.
  • Beta blockers can worsen breathing problems like asthma or COPD. Therefore, if you have breathing problems, check with your healthcare provider before taking sotalol.
  • Like all beta blockers, sotalol can make heart failure worse in some situations. However, beta blockers are also useful for the treatment of heart failure. If you have heart failure, your healthcare provider may need to monitor you closely while you take this medication. Let your healthcare provider know immediately if your heart failure symptoms seem to become worse.
  • If you will be having surgery, make sure your surgeon and anesthesiologist know you take sotalol, as it may affect the choice of medications used during the procedure.
  • Beta blockers can mask some of the symptoms of low blood sugar (hypoglycemia), particularly the "racing heart" feeling. This can cause serious problems for people with diabetes, who need to be able to sense that they have low blood sugar in order to correct it before it becomes life-threatening.
  • Beta blockers can mask some of the symptoms of an overactive thyroid (hyperthyroidism). Stopping sotalol suddenly could cause symptoms of a "thyroid storm" (a sudden and severe worsening of hyperthyroidism symptoms.
  • Sotalol can potentially interact with many other medications (see Drug Interactions With Sotalol).
  • If you have an anaphylactic allergy (the type that affects the entire body and often interferes with breathing), sotalol may make you more sensitive to the allergen and may make the usual treatments (such as epinephrine or an EpiPen®) less effective.
  • Sotalol is considered a pregnancy Category B medication. This means that it might be safe for use during pregnancy, although the full risks are not currently known (see Sotalol and Pregnancy).
  • This medication passes through breast milk in humans. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment (see Sotalol and Breastfeeding).
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