View source for Sotalol

==General==
*Type: [[Beta blockers]] 
*Dosage Forms: Tab (80 mg, 120 mg, 160 mg, 240 mg); Injection
*Common Trade Names: Sotalol

==Adult Dosing==
===Ventricular arrhythmia, life-threatening===
*80-160 mg PO q12h
**Start: 80mg PO q 12h
**Max: 640 mg/day
**Taper over 1-2wk to D/C
*75-150 mg IV q12h
**Start: 75 mg IV q12h
**Max: 600 mg/day
**Taper over 1-2wk to D/C

==Pediatric Dosing==
===Ventricular arrhythmia, life-threatening===
*<2 yo
**Dose based on [[BSA]] and age-specific factor
*2+ yo, PO
**90-180 mg/m^2/day PO divided TID
***Start: 90mg/m^2/day
***Max: 180mg/m^2/day
*2+ yo, IV
**84-168mg/m^2/day IV divided TID
***Start: 84mg/m^2/day
***Max: 168mg/m^2/day

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Category B Caution advised (esp in 2nd and 3rd trimester)
*Lactation: Possibly unsafe
*Renal Dosing
**Adult
***CrCl 30-59: Give q24h
***CrCl 10-29: Give q36-48h
***CrCl <10: Individualize Dose
***IV drug contraindicated with CrCl <40
**Pediatric
***Not defined
*Hepatic Dosing
**Adult
***No Adjustment
**Pediatric
***No Adjustment

==Indications==
*Suppression of ventricular arrhythmias refractory to other meds
*Suppression of SVT, a-fib

==Contraindications==
*Allergy to class/drug
*[[Sinus bradycardia]]
*[[Sick sinus syndrome]] w/o pacemaker
*2nd or 3rd Degree [[AV block]] w/o pacemaker
*Congenital or acquired [[QT prolongation]]
*Baseline QTc > 450 msec
*Decompensated [[heart failure]]
*[[Cardiogenic shock]]
*CrCl < 40 (IV use)
*Bronchospastic disorders

==Adverse Reactions==
===Serious===
*[[Hypotension]]
*[[Bradycardia]]
*Proarrhythmia (esp in patients with [[hypokalemia]])
*[[Congestive heart failure]]
*[[QT Prolongation]]
*[[Torsades de pointes]]
*[[Lupus erythematosus]]
===Common===
*[[Fatigue]]
*Dizziness
*[[Nausea]]/[[Vomiting]]
*[[Diarrhea]]
*Asthenia
*Hyperhidrosis
*[[Palpitations]]
*[[Headache]]
*Insomnia
*[[Dyspepsia]]
*Edema


==Pharmacology==
*Half-life: 12h
*Metabolism: None
*Excretion: Urine
*Mechanism of Action:
**Class II - Nonselective beta-blocker
**Class III effects (prolongs repol and refractoriness)
*Onset of action = 2-3hr
*Duration of action = 24hr

==See Also==
*[[Beta-blockers]]
*[[Beta-blocker toxicity]]
*[[Antiarrhythmics]]
*[[Antihypertensive medications]]

==References==
<references/>

[[Category:Pharmacology]]
[[Category:Cardiology]]