Meds and you

Updated 11 February 2013


Sotalol is indicated for the treatment of irregular heart rhythms.


Sotalol is the active ingredient of Sotacor and SotaHexal.

General information

Sotalol is indicated for the treatment of irregular heart rhythms. It does not cure this condition, but keeps it under control and is therefore prescribed to be taken long term.

Sotalol may provoke breathing difficulties due to its effect on receptors in the lungs. If you suffer from asthma or other respiratory conditions, sotalol should be taken with caution. You may also find strenuous activities more difficult, partly because of the drug's effect on the lungs, and partly because it reduces heart rate.

Beta blocking drugs may also reduce blood supply to the limbs and extremities, and may therefore cause cold hand and feet. Some men may also experience temporary impotence when taking sotalol as a result of reduced blood circulation.

Patients taking sotalol should be carefully monitored for torsades de pointes, a serious heart rhythm disturbance that may result in death.

How does sotalol work?

Sotalol reduces the stimulating effect of noradrenalin. As a result is lowers the force and speed at which the heart is beating. It also regulates the electrical impulses in the heart which cause it to beat. This assists in stabilising fast and abnormal heart rhythms.

Fast facts

Drug schedule: Schedule 3

Available as: Tablets and injection

What does it do? Sotalol stabilises irregular heart rhythms

Overdose risk: Medium

Dependence risk: Low

Available as a generic? Yes

Available on prescription only? Yes

User information

Onset of effect: Within 1 hour.

Duration of action: Up to 12 hours.

Dietary advice: Sotalol can be taken with or without food.

Stopping: Abruptly stopping after prolonged use may markedly increase blood pressure, cause chest pain and may cause fast or irregular hearth rhythms. A heart attack may even be provoked. When treatment needs to be stopped, the dosage should be gradually reduced under medical supervision.

Prolonged use: No problems expected. Your doctor may request periodic tests if you use this medication for extended periods of time.

Special precautions

Alert your doctor before using this drug if:

  • you suffer from asthma or any other respiratory condition,
  • you have or have had severe congestive heart failure in the past,
  • you have known liver or kidney disease,
  • you have a circulatory disorder,
  • you have diabetes. Sotalol may mask some of the warning signs of low blood sugar such as a fast heart rate,
  • you have an overactive thyroid. Sotalol may mask symptoms of this condition,
  • you have a medical emergency, or
  • before you have any surgery

Pregnancy: Avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: Avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.

Porphyria: This medication is safe to use.

Infants and children : Safety and efficacy of this medication has not been established for children.

Elderly: Caution is advised in the elderly as adverse effects may be more likely. A reduced dose may be needed.

Driving and hazardous work: Caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how it affects you.

Alcohol : Avoid concomitant use of alcohol as it may cause a dangerous drop in blood pressure.

Possible side effects

Side effect


Consult your doctor



Only if severe

In all cases




Dizziness/ tiredness/ weakness






Dry eyes






Chest pain or tightness



Difficulty breathing/ shortness of breath



Palpitations/ Fainting





Possible reduction in blood potassium levels. Increased risk of torsades de pointes


Possible reduction in blood potassium levels. Increased risk of torsades de pointes


Possible reduction in blood potassium levels. Increased risk of torsades de pointes

Adrenaline, noradrenaline, dobutamine

Possible risk of severe high blood pressure

Verapamil, diltiazem

Risk of severe low blood pressure and heart rhythm disturbance


Increased reduction in heart rate

Anti-malaria medication such as quinidine

Increased reduction in heart rate


Increased risk of torsades de pointes


Increased risk of torsades de pointes

Overdose action

An overdose can be fatal. Seek immediate emergency medical attention. Symptoms of overdose may include swelling of the legs, feet and ankles; shortness of breath; difficulty breathing; and a slow heartbeat.

Recommended dosage

Adults: 80-320mg once daily. Maximum daily dose of 640mg under specialist supervision.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.


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