Sotalol hydrochloride (HCL) is a medication that can control irregular heart rhythms (arrhythmias). Sotalol is used to treat irregular heart rhythms that occur in the atrium and ventricle--such as atrial fibrillation or flutter and ventricular tachycardia. Because Sotalol has blood pressure lowering properties, it has also been used to treat high blood pressure. The National Institute of Health (NIH) warns that Sotalol can also cause serious arrhythmias.
Cardiovascular Side Effects
Sotalol has the capacity to cause heart block, bradycardia (heart rate less than 60 beats per minute), and low blood pressure. Sotalol can also worsen congestive heart failure symptoms. Because of these adverse reactions, Sotalol is contraindicated in patients with a history of first or second degree heart block, bradycardia (heart rate less than 50 beats per minute) during waking hours, and history of significant CHF.
Some patients also reported having chest pain while taking Sotalol. Incidences of chest pain should be reported to a physician.
The NIH says that all patients receiving Sotalol treatment must be monitored for at least the first three days on their maintenance dose in a facility with staff trained in advanced cardiac life support. This is because Sotalol HCL may induce lethal ventricular arrhythmias during initial therapy and doses must be adjusted to the lowest possible therapeutic level.
Central Nervous System Side Effects
Sotalol may cause headache, dizziness and double vision in some people. Fatigue, weakness and general malaise have been reported. Some patients may feel depressed or have insomnia.
Gastrointestinal Side Effects
Sotalol HCL may cause nausea and vomiting in some patients. Because the medication must be given on an empty stomach either one hour before meals or two hours after meals, this adverse reaction is difficult to minimize. Dry mouth has been reported, as well as indigestion and diarrhea. Abdominal pain, abdominal distention and decreased appetite are other possible reactions.
Respiratory System Side Effects
Patients taking Sotalol HCL may develop a cough, difficulty breathing or upper respiratory infections. The lowest possible effective dose of Sotalol should be used with patients who have a history of bronchospasm--constriction of the upper airways.
References
- The National Institute of Health Daily Med Sheets
- Pearson Nurse's Drug Guide 2010; Wilson, B. A., Shannon, T. M., & Shields, K. M.; 2010.
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