Sotalol

I have been prescribed 40mg Sotalol twice a day as a starter dose and now have been prescribed an increase to 80mg twice a day. I am concerned to discover that Sotalol is no longer recommended by NICE for rate control or rythmn control. I asked my GP for an explanation and his reply was rather vague (been used for years etc). The list of common side effects is concerning. Does anyone have any experience of side effects from this drug at these doses, or is it mainly a problem at higher doses, which can go up to 320mg or 640mg daily I believe?

[CDreamer]

I was told at AFA Patient Day by a leading EP that it was a drug to avoid if you have Lone AF - ie: no other heart problems. The reason given at the time was that Sotolol has the capacity, as does any drug, to cause arrythmias as well as help them and that there had been reports of people on Sotolol developing much more serious arrythmias than AF.

It used to be good practice that GPs were unable to prescribe anti-Arrythmia drugs without secondary care ie: specialist direction.

Even when a cardiologist suggested Sotolol for me in 2007, my GP who had been a cardiologist registrar advised me against taking it and suggested Flecainide, which should again should only be prescribed by someone competent. At the time I trusted my GP rather than my Cardiologist. I was referred to someone of my choice in London and they confirmed that Flecainide, in my case, would be preferable.

I would push your GP further on his competence and experience on cardiology and the reasons for suggesting Sotolol and perhaps ask for a specialist consult.

It’s always good to ask questions and push for rational.

Best wishes CD

[Truckerclark in reply to CDreamer]

Years ago I was told sotolol was only given as a last resort drug , especially if you aren’t old ,,, my consultant told me then they would try others first , flecanide I was on for years with no real bad affects ,,I’d try get consultant cardiologist instead of doctor to speak with now ,,,,

[Hidden in reply to CDreamer]

The Sotalol had already been suggested by the EP clinic at the hospital, but my contacts with the clinic have all been with a nurse practitioner remotely rather than a cardiologist so I don't know if I am receiving ' standard policy' rather than an individual assessment. My real concern st the moment is avoiding any treatment change which could cause an 'event'.I don't want to end up in A&E for any reason at the moment even if there were any ambulances or staff available to treat me. I would prefer to keep the AF under control for a couple of months until vaccinations are available before going anywhere near any healthcare setting.

[BobD Volunteer]

I full endorse CDreamers comments. You need to challenge your GP and ask for a referal to a consultant cardiologist or Electrophysiologist

[Finvola]

Sotalol caused me to have frequent bouts of very fast heart rate after I took it for only five days. I read that it is mainly a problem in higher doses but those higher doses are necessary to control rhythm.

Flecainide has done the job well for me.

[AussieHeart in reply to Finvola]

Same ... happening now and very scared

[Finvola in reply to AussieHeart]

Aussie - have you heard of a Valsalva maneuvre? I found it could help to stop the racing.

webmd.com/heart-disease/atr...

[Diamondcat]

Hi there I am no expert but I think many of the rate/rhythm control drugs can also have a pro arrhythmia effect. I am on sotalol now but used to be on Flecainide. Just under 1 year ago it caused a major dangerous arrhythmia which landed me in recus at A&E and a 2 week hospital stay. Hence it was changed. I think with this condition it’s what works for you and just be aware of the signs that things may be going wrong. X good luck with your journey xx

[dmjtanner in reply to Diamondcat]

Yes, I understand all the anti arrhythmic drugs can cause other arrhythmias.

[Rubymurray25]

I was on 80mg of Sotalol twice a day for 2 years without any side effects but it ran its course with me and was no longer working and they didn't wish to increase the dosage so I had an ablation and was put on Flecianide. It was a stand in Cardiologist who put me on it originally and said " they " had been discussing me and thought Sotalol was the best course of action. I guess they never know until tried what is going to be best or indeed what goes on behind the scenes sometimes!

[Hidden]

I’ve taken Sotalol (currently 120 mg per day) for about two and a half years without any obvious side effects. The main thing that it doesis to slow the heart rate down-mine is usually in the high 40’s/low 50’s at night and high 50’s/low 60’s during the day. The dose that you have been prescribed is a low one so you probably have any problems with the drug. It’s an older medication that flecainide- which has various problems of its own btw- and is well tolerated by most people. I would certainly ask for more information on why it has been prescribed, but would not be unduly concerned.

[Cat04]

I took Sotalol for a couple of years prior to my ablation. No side effects and good rhythm control. It was prescribed by my EP whilst I was in hospital with a bout of AF.

[Hatten28]

Hello Mike, I have taken sotalol since 2004 was fine until February last year when my doctor advised me to take extra tablets which had a bad effect.I would say the only downside for me is they slow me down and get very tired , however I’m nearly 81 now so haven’t done too badly.

Another doctor thought I had heart failure and wanted me to see a cardiologist, however the virus did away with all other appointments so nothing still. I have a pacemaker which was replaced in May last year an£ since have had only one small episode, hope I am not speaking too soon.

My dosage of sotalol is 80 mg twice daily.

Good luck and hope you feel more confident in the future.

[SingingT]

Good morning, I get my posts late! I have been on Sotalol 40mg bd for 6 months now. I don’t feel too bad on it, more tired than I’d like to be and I have a bout of AF every 2-3 weeks for about 19 hours. It really is that specific. I took only 20mg bd for the year before that and had many more ectopics. I had no idea that NICE no longer recommend it so will ask my cardiologist about that. However, before Sotalol I took Flecainide and Bisopralol. It was only after experiencing atrioventricular block while in AF, which required my having a pacemaker, that I was put on Sotalol. My cardiologist does not recommend that I have an ablation. I’m sure there are reasons for our cardiologists/EPs prescribing as they do but I would like more info. Sometimes I think I am labelled as “anxious” for wanting that information. My heart has been dodgy since birth and I had bacterial endocarditis when I was 19yrs old which could have left scarring. In the end I guess it’s a case of “what works for you”. My QOL is OK so I won’t be rocking the boat too much. BTW I am a 74 yr old female Brummy now living in rural Scotland.

[Clarrie]

I have been on Sotalol for about five years now with no side effects. I started on 80mg twice a day and have been taking 140mg twice a day since June last year. I also take an extra 80mg when I go into AF.

[dmjtanner]

I have been using Sotalol 40mg twice a day for 3 years and haven’t had any problems with it. It is still used in the US. Good luck!

[101448]

I was put on Sotalol. I quickly became very symptomatic. Extremely low heart rate, dizzy, nausea, chest pain, just horrific. I changed cardiologists , immediately taken off Sotalol, and I feel totally fine on metropalol 25 mg twice a day.

[AussieHeart]

Just put on it and third day got bad reflux, shaking legs. First day headachey and loose bowels. Think I need to go off it as also getting shakes

[Dee5165]

I was placed on 40 mgs of Sotalol to start when I was diagnosed with Afib in January. It did not work. I was told 40 mgs. does not have any anti-arrhythmia benefits. Sotalol was increased to 80 mgs. Worked for only one week. Cardiologist increased dosage to 120 mgs. Side effects were awful. No QOL. (Quality of Life) Dropped back to 80 mgs. and added magnesium Taurate/Glycinate, Wild Alaskan Fish Oil, Hawthorn Berry instead 2 to 3 times a day. Takes 8-10 weeks to have benefits but was worth it. BP now normal and Afib temporarily gone.