Sotalol Complications

Sotalol is an oral medication primarily used to treat sustained ventricular tachycardia, a permanently fast heartbeat. This particular form of arrhythmia causes the chambers of the heart to fill improperly and thus supply insufficient blood to the body. Sotalol is a beta blocker used to slow and regulate the heartbeat. Though sotalol is FDA-approved and considered a safe treatment for this condition, some complications may arise during therapy.

Use Only as Directed

• Improper use of sotalol may result in a return or worsening of your symptoms. Take your sotalol dose(s) at the same time every day. Follow your physician's directions and do not adjust your dosage or stop taking sotalol without consulting your physician. Refill your medicine before you take your last dose to avoid missing doses.

Side Effects

• Typical side effects include dizziness, tiredness, slow heartbeat, headache or diarrhea. Some patients, both male and female, have reported a decreased ability to participate in sexual activity. Contact your doctor if these side effects persist or impair your daily life. An adjustment in dosage may alleviate these symptoms. In rare cases, patients have reported severe dizziness, fainting, sudden change in heartbeat, or pain in the left jaw, arm or leg. Seek immediate medical attention if you experience any of these symptoms.

Antacids

• The minerals in antacids prevent the absorption of sotalol and decrease its effects on the heart. Do not take sotalol at the same time as an antacid containing magnesium, calcium or aluminum. If you require an antacid, take it at least two hours before or after your sotalol dose.

QT Prolongation and Torsade de Pointes

• In rare cases, patients may experience an extreme slowing of the heart rate characterized by a pronounced QT prolongation on an electrocardiograph (ECG) reading. An ECG records a heartbeat as a Q-wave, the pronounced spike, and a T-wave, the shorter, less pronounced wave following the Q-wave. QT prolongation is a lengthening of the QT wave complex on a ECG reading, indicating that the heart muscle requires a longer recovery time between heartbeats. The risk of QT prolongation increases the longer a patient is on sotalol and may result in a severe condition known as torsade de pointes, a spontaneous and temporarily irregular heart rate. Torsade de pointes is characterized by an "upside down" heartbeat on an electrocardiogram.

Effects on Diabetes

• The intended action of sotalol may mask the increased or pounding heart rate associated with sudden, acute hypoglycemia, or low blood sugar. In addition, sotalol may increase the incidence of hyperglycemia, high blood sugar. Patients who take sotalol while also taking medication to treat diabetes should monitor their blood sugar regularly and work closely with their diabetes physician to adjust insulin or oral diabetic medicines to compensate for these effects.

Pregnancy and Nursing

• Sotalol is a Category B pregnancy drug, meaning that animal studies are inconclusive and no well-controlled studies have been conducted on pregnant women. In cases where patients have taken sotalol during pregnancy, their physicians reported low birth weights. Take sotalol during pregnancy only when the benefits outweigh the risks and while under medical supervision. The medicine transfers from mother to child while nursing. The attending physician will decide if it is better to discontinue therapy while nursing or to bottle-feed the child and continue or resume sotalol therapy.