Sotalol, Sorine

Introduction

Written by Patricia Weiser, PharmD
Medically reviewed by Brittany A. Duke, PharmD, RPh
Updated on October 30, 2023

Sotalol (SOE ta lole) is a generic medication prescribed for certain arrhythmias (heart rhythm problems). It belongs to a group of drugs called antiarrhythmics. It’s also a beta-blocker.

Boxed warning: Risk of serious heart rhythms

Sotalol has a boxed warning about the risk of serious irregular heart rhythms. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

For details, see the “Interactions and warnings for sotalol” section.

Side effects of sotalol

Sotalol may cause mild or serious side effects. More common mild side effects of sotalol and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about sotalol’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for sotalol listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of sotalol are listed below. These side effects may differ based on the form of sotalol prescribed.

This article doesn’t include all possible mild side effects of the drug. To learn more about sotalol’s side effects based on the form, refer to the prescribing information for sotalol listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Sotalol oral tablet’s mild side effects include:

• fatigue
• slow heart rate
• labored breathing
• dizziness
• mild allergic reaction*

Sotalol injection’s mild side effects include:

• slow heart rate
• labored breathing
• fatigue
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for sotalol” section.

Serious side effects

Serious side effects of sotalol are listed below. These side effects may differ based on the form of sotalol prescribed.

This article doesn’t include all possible serious side effects of the drug. To learn more about sotalol’s side effects based on the form, refer to the prescribing information for sotalol listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, sotalol’s serious side effects include:

• low blood pressure
• heart failure
• heart block (a disturbance in the electrical signals that control your heart rhythm)
• boxed warning: risk of serious heart rhythm changes*
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for sotalol” section.

Common questions about sotalol

Below you’ll find answers to a few commonly asked questions about sotalol.

Is it safe to eat bananas while taking sotalol?

Yes, it is generally safe to eat bananas while taking sotalol. Bananas are a good source of potassium, which is an important nutrient.

People with low blood levels of potassium should not take sotalol due to the risk of harmful effects, including serious heart rhythm changes. Your doctor may check your potassium level before prescribing sotalol. If it’s too low, they’ll likely prescribe a potassium supplement. This approach works better for treating low potassium than eating bananas or other potassium-rich foods.

If you have concerns about your potassium or diet while taking sotalol, talk with your doctor for personalized guidance.

What brand names are available for sotalol?

Currently, the following brand-name versions of sotalol are available:

• Betapace oral tablet
• Betapace AF oral tablet
• Sorine oral tablet
• Sotylize oral liquid solution

Sotalol is a generic drug. Available forms of the generic include oral tablets and injection that’s given as an intravenous (IV) infusion (an injection given into your vein over time).

A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less than brand-name drugs.

Talk with your doctor or pharmacist if you have questions about how these drugs compare.

How does sotalol work? And how long does it take to start working?

Sotalol works to treat or help prevent certain arrhythmias (heart rhythm problems). It attaches to beta receptors in the heart and body, which keeps them from receiving chemical signals. (Receptors are proteins that only certain molecules can attach to.) It also slows the heart’s electrical signals. Both of these types of signals help control the speed and pattern of your heart rate.

Sotalol oral tablet starts working within a few hours. It may take a few days to reach its full effect. Sotalol IV injection starts working within minutes. It may take a few hours to reach its full effect. But it may take more or less time, depending on how your body responds to the drug. You and your doctor will monitor your heart rate and rhythm to find out how well sotalol is working for you.

If you’d like to know more about sotalol’s mechanism of action (how it works), talk with your doctor or pharmacist.

Uses of sotalol

The Food and Drug Administration (FDA) approves prescription drugs such as sotalol for certain conditions. Approved uses for sotalol are described below.

Use for certain heart rhythms

Doctors may prescribe sotalol oral tablet or sotalol injection given by intravenous (IV) infusion to treat or help prevent certain arrhythmias (heart rhythm problems). It’s used for these purposes in children of all ages and adults. It may be prescribed as a short-term or long-term treatment.

Specifically, sotalol is prescribed to:

• maintain usual heart rhythm to prevent atrial fibrillation (AFib) or atrial flutter (“atrial” refers to the upper chambers of the heart)
• treat life threatening ventricular arrhythmias (heart rhythm problems involving the lower chambers of the heart)

Doctors may not prescribe sotalol oral tablets in certain situations, such as for people with mild AFib or atrial flutter. This is because mild cases may be more easily treated using other methods with fewer risks than sotalol. Also, sotalol has not been shown to prolong survival in people with life threatening ventricular arrhythmias.

Interactions and warnings for sotalol

Below, you’ll find information about sotalol’s possible interactions and warnings.

Interactions of sotalol

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take or use sotalol, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for sotalol” section below.

Warnings for sotalol

Some people should not take sotalol, and others should use it cautiously.

Boxed warning: Risk of serious heart rhythm changes

Sotalol has a boxed warning about the risk of serious heart rhythm changes. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

Sotalol may cause serious heart rhythm changes that can be life threatening. Doctors may refer to this as QT prolongation or long QT syndrome. This side effect was rarely reported in studies* of sotalol.

Symptoms may include chest pain, shortness of breath, lightheadedness, or palpitations.

If you have concerns about this warning, tell your doctor. They’ll likely monitor your heart rate and rhythm regularly throughout sotalol treatment.

To learn more, talk with your doctor or pharmacist.

* For details about sotalol’s studies, see its prescribing information in the “Resources” section below.

Other warnings

Sotalol could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether sotalol is a safe option for you.

Ask your doctor about specific warnings for sotalol, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Sotalol can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to sotalol or any of its ingredients, your doctor will likely not prescribe sotalol. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to sotalol, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of sotalol

You should not take or use more sotalol than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much sotalol, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and sotalol

Information about sotalol and pregnancy and breastfeeding is described below.

Sotalol and pregnancy

There are risks with sotalol treatment during pregnancy. But there are also risks with having untreated heart rhythm disorders while pregnant. (Keep in mind that sotalol is used for treating or helping prevent certain heart rhythm disorders, some of which can be life threatening.)

If you’re planning a pregnancy or can become pregnant, talk with your doctor about your heart rhythm treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether or not you should take sotalol during pregnancy.

Sotalol and breastfeeding

There are risks with sotalol treatment while breastfeeding. For instance, sotalol may cause low blood pressure and slow heart rate in a breastfed child.

But there are also risks with having untreated heart rhythm disorders during this time. (Keep in mind that sotalol is used for treating or helping prevent certain heart rhythm disorders, some of which can be life threatening.)

If you’re planning to breastfeed, talk with your doctor about your treatment options. Together, you can discuss the risks and benefits of your treatment options. Your doctor may recommend other healthy ways to feed your child.

What to ask your doctor

Let your doctor know if you have questions about sotalol or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Is it safe to continue my other prescription and over-the-counter medications during sotalol treatment?
• How long will I need to take sotalol?
• How can I tell the difference between the symptoms of my condition and the possible heart-related side effects of sotalol?

Resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Sotalol hydrochloride injection, for intravenous use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/ff3061ab-d930-4318-a5be-684e38be229e/spl-doc
• Sotalol hydrochloride tablets, for oral use; sotalol hydrochloride AF tablets, for oral use. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/1900c87a-0610-4d74-a814-9286bcad6b2f/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.