Sotalol

I have just been prescribed Sotalol (2x 40mg per day- a low dose) for newly diagnosed paroxysmal atrial fibrillation. Does anyone know if this medicine is likely to cause weight gain? Also, I sometimes feel that my concentration and memory are slightly impaired (Eg I inadvertently put some groceries into a shopping bag instead of the bagging area- not something I would normally do). This could, of course, be the result of anxiety following the afib rather than the afib itself, but I wondered what the experiences of others on this medication are? I have been taking Sotalol for nearly two weeks.

[doodle68]

Hello Samazeuilh welcome . Where are you living, Sotalol is rarely used here in the UK.

If you look under your post there is a 'related tag' with the word SOTALOL , click on it for more posts on the subject.

There is a link here too...

healthunlocked.com/search/s...

[Hidden in reply to doodle68]

Thanks for the reply. I am living in the U.K. It was prescribed by the local hospital. My GP simply commented that it was “stronger than the usual medication” but Inwas on a low dose. Not sure why they chose this particular medication. I will have a look at the other posts on this topic.

[doodle68 in reply to Hidden]

Hi Samazeuilh I have read that although not much used here Sotalol is occasionally a first use option rather than used indefinitely so you may be changed to another beta blocker later in which case weight gain won't be a concern.

[Bshersey in reply to doodle68]

I take 120 mg of Sotalol 2x daily. I am in Boston. I started at 80 but then moved to 120 when my afib reappeared. At the 120 dose, it basically controlled my afib. But I had an ablation anyway in February. My biggest problem with sotalol was the three-day required hospital stay when I went on it. Apparently, you can react adversely to it with dire consequences. But otherwise, I have been OK. I have actually lost some weight. And I don't feel tired, like some complain. Now I am just waiting for EP to take me off it since ablation was a success.

[Hidden in reply to Bshersey]

Thanks to you, Hoski and BobD for your replies. I rang the manufacturer earlier and they are going to get someone from their medical team to call me tomorrow. I’ll post anything which sounds significant here. Sotalol seems to have fairly mixed reviews here- likely it’s a matter of how an individual reacts.

[Hidden]

Sotalol is commonly used here in the USA. It is a combination drug with antiarrhythmic and beta blocker properties so it can regulate the rhythm and rate of your heart. 40 mg is a small dose, your doc may be starting low and eventually raise the dose if needed. My docs deny that betablockers cause wt gain but we patient know thats not true. The drugs can slow our metabolism, so we need to stay active and eat healthy to avoid the weight gain. Im trying hard to drop weight. I am losing slowly but not easily😂 I was given sotalol in the beginning but had trouble with the betablocking part made my heart go too slow so now I have flecainide, which I tolerate fine.

[BobD Volunteer]

It is not generally used as it is a rather dirty drug and can cause other arrhythmias but some EPs do still occasionally use it. It has both beta blocker and anti arrhythmic properties.

[RexH in reply to BobD]

Yes, it was a nasty drug for me.

Made my heart so slow nearly stopped. So had to go straight to ablation. So far so good. 2 years now, see cardiologist next week for review.

[Kaz747]

I’m in Australia and I’m on 120mg Sotalol twice daily. I was initially put on Verapamil and then switched to Flecainide but neither controlled my arrhythmias so I was put on 40mg Sotalol twice daily for 9 months, then upped to 80mg when I ended up in hospital with Aflutter and then 120mg 6 weeks later when back in hospital with AFib. Having ablations in 2 weeks so hoping to be off medication soon after that. It makes me tired so I need to ensure I get out and exercise and eat healthy - I have lost about 3 kg whilst on the higher dose but I’m being very focused on my diet aiming for 1200-1400 calories a day (having occasional treats 🍨🍿)

[hock217 in reply to Kaz747]

Same here....how do you get out and exercise when sleeping 12 to 16 hrs a day and weak. I lost 30 lbs and my hair n eyebrows. Sotalol led to diverticulitis which probably caused Malabsorption. Ablation was easy for me. Don't want a bag hanging from below my waist. Guess I need to consult with cardiologist and EP. Perhaps cardiac rehab gym where monitored is good option. Sorry to go on n on but I had an episode this morning worse than the original one 18 mths ago.

[Kaz747 in reply to hock217]

It's not a lot of fun is it? 😑

[Hidden in reply to hock217]

Are these side effects definitely attributable to the Sotalol? From memory, I don’t think that hair loss is listed as a side effect (or if it is itnis “rare”). Same for diverticular disease. Hope you are starting to feel better.

[hock217 in reply to Hidden]

I had diverticulitis twice in past. GI doc states deep diverticula pockets and damaged narrow sigmoid colon. Between sleeping a lot after ablation and Sotalol and no exercise, yes I believe it led to diverticulitis.......for me. Hair falling out, patches of crusty growths on skin. Saw holistic MD for 10 tx. Gained 10 lbs and my hair has grown back n skin cleared. In short, it was Malabsorption due to crust covered diverticula. Still take Diatomaceous Earth food grade as well as Metamucil as it worked. Our immune systems need as much if not more care as our illness. American Doctors do not focus on that. My Grandmother was a holistic healer before I was born so explored here in NYC.

[brucewtb]

I am on 120 mg of Sotalol - 80 in the evening and 40 in the morning. Still commonly prescribed in Australia for AF. However before I could go on it permanently I had to have a pacemaker inserted as initially Sotalol dropped my heart rate as low as 28. The main issue I have is that my heart rate gets capped at about 100 which I means hit the wall much sooner with high intensity aerobic exercise eg cross country skiing and bike riding up steep hills. AF is mostly controlled so I don't notice it but six monthly downloads of pacemaker data show that I in fact have quite a lot of very brief AF episodes totaling about 2 hours in the six months.

[Hidden in reply to brucewtb]

My heart rate at rest was- prior to the Sotalol-about 60, whereas it is now around 50 at rest. It seems to have suppressed the PAF (so far as I can tell) but it’s early days yet- I have only been on it for a couple of weeks. Your 2 hours over 6 months doesn’t sound too bad, and you can monitor it to see if it gets better or worse over the next months.

[brucewtb in reply to Hidden]

My resting heart rate prior to Sotalol was about 50-53 so I guess a bit too low to be put on Sotalol and that is how it turned out. I was only on it for a couple of days when the decision was made to have a pacemaker inserted due to the drastic heart rate lowering effect of Sotalol. Heart rate doesn't drop below 60 now despite the Sotalol. The main issue with the large number of small AF episodes is the risk of stroke when going in and out of AF. Any way I will be seeing my regular cardiologist on Friday to have all this reviewed.

[sleeksheep in reply to brucewtb]

I,m in WA and the specialists here dont like Solatol as BobD has mentioned.

My first appointment with him , his first comment was "why are you on sotalol "

Samazeuilh those side effects are what I experienced , foggy memory , lethargy, generally feeling exhausted and yes weight gain or inability to lose weight.

[brucewtb in reply to sleeksheep]

Interesting. I am under two cardiologists one who visits Merimbula from Melbourne who I have been seeing for a number of years and another in Canberra who put in the pacemaker and they both seem to be quite keen on Sotalol as is my GP. I think I would be reluctant to switch to something else unless the side effects got worse - I have kinda got used to it. Weight gain has me concerned though - I use the 5:2 diet to control this. Before all the AF business and new drugs (I also had to go on Apixaban) I found being on the 5:2 diet an easy way to quickly loose weight - not any more.

[sleeksheep in reply to brucewtb]

I was put on Sotalol in 2010 as a public patient so I only ever saw the registrar for the cardiologist at Charlie Gardner Hospital here in Perth.

It never worked with me besides making the heart beat very slow . I still went back into AF. I decided to go private and see a specialist in 2016 , best decision I ever made.

I,m now on Flecainide 50mg x 2 , and the change in lifestyle is immense.

Lose weight easily , can drink in moderation and to all seems and purposes lead a totally normal life.

But I do understand that every person reacts differently.

[hock217 in reply to brucewtb]

Do you have extra useless nodes. I did "node to nowhere" ...only monitor detected it. 120 to 160 extra beats. ECG, EKG does not pick it up

[Hidden in reply to brucewtb]

2 hours over 6 months would be pretty good, wouldn’t it?

[Cat04]

I have not noticed any significant weight gain, I am in UK and was started on Sotalol 80mg twice daily, last November by my EP to 'try to stop me going into AF' I also know of others on sotalol for PAF. The NICE regs are as follows

bnf.nice.org.uk/drug/sotalo...

My concentration levels are bad at the best of times so I don't think I'm qualified to comment since starting sotalol 😞

[Melleray]

Hi - I have been taking Sotalol for 18 years - first on 40mg twice daily, then up to 80 mg after a few years. I have no weight gain or other side effects that I am aware of.

[Hidden]

Hi I am in the UK and I was put on sotalol 80mg but after 3 weeks I stopped it via my gp as it didn't make me feel very good at all. But I have a problem with all beta blockers. I was concerned that I wasn't in hospital being monitored when I was put on it which is what the guidelines say and as our USA friends have said.

[hock217 in reply to Hidden]

I was put on Sotalol after ablation but not monitored in hospital. 40 mg BID. I stopped it 10 days ago. Had an episode like my original one that sent me to cardiologist 18 mths ago. Very scary.....while on toilet. Hot sweat, weak, faint. When able, walked ten steps to my bed. Feel like crying. Plan things when feeling ok but don't go if episode happens before. Had hope ablation meant I could live a relatively normal, sometimes normal life. Supposed to attend a concert in a lovely park tonight with friends....canceling AGAIN.

[Aqua_1]

I started off on Sotalol 40mgx2 and it didn't work for me. My cardio then increased the dose and I felt even worse and had daily AFIB attacks. I also felt quite depressed when I was taking this drug.

[Janith]

I have been on sotalol lowest dosage ... for approximately one year. Zero afib attacks. It does give me a little brain fog. No weight gain. It seems to work. I am afraid to go off of it. Beautiful quality of life overall. Give it more time ... have ekg readings every three months because of qt interval. I am in USA.

[hock217 in reply to Janith]

Janith, I'm in U.S. too. Same Rx but sleeping all the time and ended up hospitalized with diverticulitis. My digestion. Slowed along with heartbeats. Guess it's time to see EP again....another month on monitor? Another Rx? Another ablation?

[Hidden]

I was on Sotolol for 7 months. Doses as low as 40 twice a day to 120 twice a day. I had an Ablation in January. During that time I put on 10 lbs without a change in diet. I stopped taking Sotolol in May and have not been able to lose the lbs. even though I have tried. My hair is also a mess. It is falling out, with sores on my scalp. The hair itself is so fly away that I can not keeps it out of my face. I’ve started pulling it back all the time. I would cut it off and let regrowth hopefully be stronger but my friend would be very unhappy with me. Good luck to you. I am much better now with only occasional flutter.

[lavinia1949]

I was put on Sotalol 40 mg morning / night by EP ( who I saw privately ) in April this year. After a week I had to take 80mg Sotalol morning / night. I felt absolutely terrible the whole time, giddy , nauseous, taste changes ,headaches and a fast big weight gain. In recent weeks since a DCCV I have finally got my medication changed by the hospital back to Bisoprolol. I still have the weird taste issues and now have the weight to shift which has always been a problem as I am hypothyroid. I would personally avoid at all costs this nightmare medication and rue the day I got put on it.

[GolfMyrtleBeach]

I was on SOTALOL 120 x 2 here in the States but it was relatively ineffective at keeping me in NSR. ( there was no 3 day hospital stay for me when I started on it, but perhaps because I had been on several others it was felt I would tolerate with no problem.) It lowered my resting heart rate to 48-50 and I found that I lacked energy - no weight gain though.

I was advised to try Tykosyn - 150 x 2 - ( dofetilide) last year ( that DID require a 3 day stay) and it has been a great drug so far. I do not believe it is available outside the US though.