Sotalol: Difference between revisions
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==See Also== | ==See Also== | ||
*[[Beta-blockers]] | |||
*[[Beta-blocker toxicity]] | |||
*[[Antiarrhythmics]] | *[[Antiarrhythmics]] | ||
*[[ | *[[Antihypertensive medications]] | ||
==References== | ==References== | ||
Latest revision as of 01:20, 7 March 2021
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
- 90-180 mg/m^2/day PO divided TID
- 2+ yo, IV
- 84-168mg/m^2/day IV divided TID
- Start: 84mg/m^2/day
- Max: 168mg/m^2/day
- 84-168mg/m^2/day IV divided TID
Special Populations
- 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
- Adult
- Hepatic Dosing
- Adult
- No Adjustment
- Pediatric
- No Adjustment
- Adult
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