Sotalol may cause QT prolongation (an irregular heart rhythm that can lead to fainting, loss of consciousness, seizures, or sudden death). For the first three days you take sotalol, you will have to be in a facility where your heart can be monitored. Tell your doctor if you or anyone in your family has or has ever had long QT syndrome (an inherited condition in which a person is more likely to have QT prolongation) or if you have or have ever had or you have or have ever had low levels of potassium in your blood, slow or irregular heartbeat, heart failure, or kidney disease. Your doctor may tell you not to take sotalol. Make sure you have discussed any medications you are currently taking or plan to take before taking sotalol with your doctor and pharmacist. If you experience any of the following symptoms, call your doctor immediately: fast, pounding, or irregular heartbeat; fainting; or loss of consciousness.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to sotalol. Your heart rhythm should be checked regularly to determine your response to sotalol. Your doctor will also want to follow your kidney function and blood level of potassium closely while you are taking sotalol.
Talk to your doctor about the risks of taking sotolol.
Why is this medication prescribed?
Sotalol is used to treat certain types of serious, life-threatening ventricular arrhythmias (abnormal heartbeats). Sotalol is also used to treat people who currently have normal heart rhythm, but have had symptomatic atrial fibrillation or atrial flutter in the past. Sotalol is in a class of medications called antiarrhythmics. It works by acting on the heart muscle to improve the heart's rhythm.
How should this medicine be used?
Sotalol comes as a tablet and solution (liquid) to take by mouth. Sotalol tablets are usually taken two or three times a day. Sotalol oral solution is usually taken once a day in adults and three times a day in children. Take sotalol consistently, either with food or without food each time. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sotalol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor will probably start you on a low dose of sotolol and gradually increase your dose to allow your body to adjust to the medication.
Sotalol controls your condition but does not cure it. Continue to take sotalol even if you feel well. Do not stop taking sotalol without talking to your doctor. If you suddenly stop taking sotalol, you may experience serious heart problems such as angina (chest pain) or heart attack. Your doctor will probably want to decrease your dose gradually over 1 to 2 weeks. Your doctor will watch you carefully and will probably tell you to avoid physical activity during this time.
Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking sotalol,
- tell your doctor and pharmacist if you are allergic to sotalol, other medications, or any of the ingredients in sotalol tablets or oral solution. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking sotalol. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- if you are taking aluminum- or magnesium-containing antacids (Maalox, Mylanta), take them at least 2 hours before or after sotalol.
- in addition to the condition listed in the IMPORTANT WARNING section, tell your doctor if you have asthma or other lung disease. Your doctor may tell you not to take sotalol.
- tell your doctor if you have or have ever had heart disease, diabetes, low levels of magnesium in your blood, or an overactive thyroid gland. Also tell your doctor if you have ever had a serious allergic reaction to a food or any other substance.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking sotalol, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking sotalol.
- you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
- you should know that sotolol may increase the risk of hypoglycemia (low blood sugar) and prevent the warning signs and symptoms that would tell you that your blood sugar is low. Let your doctor know if you are unable to eat or drink normally or are vomiting while you are taking sotolol. You should know the symptoms of low blood sugar and what to do if you have these symptoms.
- you should know that if you have allergic reactions to different substances, your reactions may be worse while you are taking sotolol and your allergic reactions may not respond to the usual doses of injectable epinephrine.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What side effects can this medication cause?
Sotalol may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- excessive tiredness
If you experience any of the following symptoms, call your doctor immediately:
- shortness of breath or wheezing
- swelling of the feet and lower legs
- unusual weight gain
- chest pain
- fast, slow, or irregular heartbeat
- severe diarrhea, unusual sweating, vomiting, decreased appetite, or excessive thirst
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).
What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.
In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include:
- irregular, fast, or slow heartbeat
- fatigue or weakness
- difficulty breathing
- cough or wheezing
- swelling of the hands, feet, ankles, or lower legs
What other information should I know?
Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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