Sotalol

What is sotalol?

Sotalol is a prescription-only medicine used to treat certain irregular heart rhythms (arrhythmias), such as atrial fibrillation. It belongs to a class of drugs called beta blockers, which help manage heart rate and rhythm. Sotalol comes in tablet form and is used under close medical supervision[1]. 

What is sotalol used to treat?

Sotalol is primarily prescribed to treat[1]: 

• Atrial fibrillation (AF) 

• Other types of irregular heart rhythms (arrhythmias) 

These conditions can increase the risk of stroke or heart failure if not treated effectively. 

How does sotalol work?

Sotalol slows down the electrical signals in the heart, helping it beat more steadily and at a regular rate. At higher doses, it also stabilises the rhythm of the heart and helps it pump more efficiently. It starts working within about 4 hours, although full effects may take 2 to 3 days[1]. 

Who can take sotalol?

Sotalol is suitable for most adults and some children over 12 years old. In children under 12, it may be used under specialist advice. You should speak to your doctor if you[1]: 

• Have low blood pressure or a very slow heart rate 

• Have recently had a heart attack or have worsening heart failure 

• Suffer from kidney disease, metabolic acidosis, or severe diarrhoea 

• Have asthma or other serious breathing problems 

• Have severe circulation issues such as Raynaud’s syndrome 

• Are allergic to sotalol or other beta blockers 

• Have an overactive thyroid 

• Are pregnant, panning to be pregnant or breastfeeding 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of sotalol?

Sotalol tablets are available in 40mg, 80mg, and 160mg strengths. The typical daily dose is between 80mg and 320mg, taken once or twice daily depending on your condition and your doctor’s instructions[1]. 

How do you take sotalol?

Take sotalol exactly as prescribed. The first dose may make you feel dizzy, so it is often taken at bedtime. If tolerated well, it can then be taken in the morning. If you’re prescribed two daily doses, space them out evenly – usually morning and evening. You should continue taking it even if you feel well, as it helps control your heart rhythm.  

Can you stop taking sotalol?

Do not stop taking sotalol suddenly without speaking to your doctor or pharmacist. Stopping abruptly may cause your heart rate to speed up, trigger arrhythmias, or lead to chest pain. Your doctor may advise you to reduce the dose gradually if stopping is necessary[1]. 

What do you do if you take too much sotalol?

Taking too much sotalol can cause serious side effects such as[1]: 

• Dizziness 

• Fainting 

• Very slow heartbeat 

If you suspect an overdose, contact your doctor immediately or call NHS 111. If symptoms are severe, go to A&E right away. 

What do you do if you forget to take sotalol

If you forget a dose, take it as soon as you remember. If it’s nearly time for your next dose, skip the missed one. Do not take two doses at once[1]. 

How do you store sotalol?

Keep sotalol in a cool, dry place, away from moisture and direct heat. Store it in the original packaging and keep it out of sight and reach of children[1]. 

What medicines can’t you take with sotalol?

Sotalol may interact with certain medications, so always check with your doctor or pharmacist before starting anything new. Avoid combining sotalol with[1]: 

• Other heart rhythm medications unless advised 

• High blood pressure medicine (e.g., diltiazem or verapamil) 

• Medicines that can lower your potassium levels (e.g., furosemide, prednisolone) 

• Diuretics (water tablets), which can affect potassium levels 

• Antidepressants or antipsychotics that affect heart rhythm (e.g., citalopram, amitriptyline) 

• Diabetes medicine (e.g., metformin or insulin) 

• Allergy medicine (e.g., ephedrine, noradrenaline, or adrenaline) 

• Asthma or COPD medications, which may become less effective or worsen breathing 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of sotalol?

Like all medicines, sotalol can cause side effects. Some are mild, but others require medical attention. Common side effects include[1]: 

• Dizziness 

• Feeling sick (nausea) 

• Tiredness 

• Diarrhoea 

• Headache 

Less common but serious side effects[1]: 

• Very slow heartbeat or other heart problems including chest pain or palpitations 

• Breathing difficulties 

• Thrombocytopenia (low platelets) 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about sotalol

How quickly does sotalol work? 
It starts working within about 4 hours, but it may take 2 to 3 days to feel the full effect[1]. 

Can I drink alcohol while taking sotalol? 
Yes, but it’s best to limit alcohol because it can affect your heart rhythm and blood pressure[1]. 

Can I take sotalol with food? 
Yes, it can be taken with or without food[1]. 

What if I feel dizzy after taking sotalol? 
Lie down and rest. Contact your doctor if dizziness persists[1]. 

Can I drive while taking sotalol? 
Avoid driving if you feel dizzy, tired, or lightheaded[1]. 

Is sotalol safe during pregnancy? 
Speak to your doctor – it may not be recommended during pregnancy[1]. 

Can children take sotalol? 
Yes, but only under the supervision of a specialist[1]. 

For the official NHS guide to sotalol, visit their website.