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Sotalol instead of Flecainide and Bisoprolol

RonSym profile image
15 Replies

I've been on Flecainide and Bisoprolol for seven years .

I have had some dizzy spells in the last two weeks and yesterday I was taken to hospital with a high heart rate (125) and they found a blood infection, for which they've prescribed antibiotics.

But they've also replaced the Flecainide and Bisoprolol with Sotalol. What difference will this make?

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RonSym
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15 Replies
BobD profile image
BobDVolunteer

Interesting thing to do as Sotalol has a mixed profile. It has both anti- arrythimic and rate control functions but fell from popular use a few years ago. Maybe old school cardiologist saw you. I would discuss with your usual specialist when you can if you do not get on with it.

jeanjeannie50 profile image
jeanjeannie50 in reply toBobD

Bob, my EP is young and he preferred me to be on Sotalol to Flecainide. Unfortunately, it didn't suit me so had to go back on Flec, but he said try and reduce my dose from 100mg twice daily. It made me think he knew Flec wasn't good. I did manage to get it down to 50mg. Now a cardiologist after looking at my ECG has said to stop my Flec as causing problems. I think you'll find that Sotalol is still used fairly regularly.

dedeottie profile image
dedeottie in reply tojeanjeannie50

Me too. I was changed from flecanide to a high dose of sotalol when flec started to cause me problems. Sotalol was actually a better drug for me as caused less problems and side effects. X

Fibber222 profile image
Fibber222

I have taken Sotolol for about 3 years and am on the max dose now. I’ve had no problems except like you a faster heart, irregulsr rhythms & and few dizzy spells the last few weeks. During this timeI was going through very high levels of stress. Things hopefully settled down yesterday to NSR & no dizziness after stress abated. ( I’m hoping this is the answer). In my opinion it’s worth a try.

Ppiman profile image
Ppiman

In the US, where prescription figures can be more easily found, sotalol remains a popular treatment for heart arrhythmias in a similar range of prescriptions to flecainide. The two drugs have some different mechanisms of action so sometimes one is likely to be considered more suitable depending upon the specific characteristics of your heart.

rbht.nhs.uk/our-services/at...

Steve

Cat04 profile image
Cat04

Sotalol is certainly making a comeback, it is listed on a lot of sites, including NHS & NICE as a drug to use for rate/rhythm control. It seems to be my (young) EP's first choice where bisoprolol is not working.

Bluetonic profile image
Bluetonic

My EP went ballistic when he found out that an A+E cardiologist had replaced bisoprolol with sotalol.

I have been put on Sotalol a year and half ago by my young EP, 80mg twice a day. I am pretty much as physically active as before. At the beginning I had blurry vision but it disappeared as I got used to the medication The only side effect for me is cold fingers in the winter.

Bolander profile image
Bolander

I've been on Sotalol 80mg twice a day for several years now with no problems, after a bad experience with Amiodarone. I t has kept me in normal sinus rhythm after a cardioversion with a heart rate around 60.

mav7 profile image
mav7 in reply toBolander

Thanks for sharing.

My cardiologist has offered the same, a cardioversion followed by sotalol.

Were you previously in paroxysmal or persistent AFib ?

RonSym profile image
RonSym in reply tomav7

Sorry, I dont recognise the word 'paroxysmal', so it must have been the other one (persistent)

mav7 profile image
mav7 in reply toRonSym

Paroxysmal is not being in AFib all the time - just sometimes frequent times

Persistent is being in AFib continuously and not in normal sinus rhythm. (NSR)

Persistent can be more difficult to revert back to NSR.

Az49 profile image
Az49

I was on max dose of flecainide and bisoprolol, for AF which did very little. Changed to Sotalol 120 mg twice a day and was in sinus rhythm overnight.

And still am 6 months later.

Bolander profile image
Bolander

Although it was originally thought to be paroxysmal AF just before the cardioversion it had been decided that it was in fact atrial flutter.

Ecki profile image
Ecki

I've been on sotalol for nearly 4 years now, no issues except cold fingers and toes. It suits me much better than bisoprolol, much less fatigue. I can do normal things like a long walk and a bike ride on the same day. 8 couldn't have done that on bisoprolol.

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