Sotalol

Chemical

Class III antiarrhythmic

Use

  1. Life threatening arrhythmias
  2. Maintenance SR in patients with AF

Presentation

Tablets: 80/60/120mg

IV: 150mg/mL

Dose

80 – 640mg/day

Route

IV/PO

Racemic mixture

D&L isomer

L isomer = β adrenergic blocking

D&L = prolong AP

MoA

  • Inhibits potassium channels
  • Prolongs repolarisation
  • Lengthens effective refractory period
  • Lengthens QT interval
  • ↓automaticity
  • Slows AV conduction
  • Β-blocking → competitive antagonist of β1 & β2 receptors

ECG: ↓HR, QT prolongation

PK

A

OBA 90%

D

No PPB

M

No 1st pass effect

E

Kidney, unchanged

t ½ 12hrs

Adverse Effects

  • Bradycardia
  • Heart failure
  • ↓BP
  • TdP (dose related)
  • Bronchospasm
  • Hypoglycaemia