Sotalol

What is sotalol?

Sotalol (brand names: Betapace®, Sorine®, Sotylize®, Sotamol®, Sotacor®, Rylosol®, Linsotalol®) is a beta-adrenergic blocker used to treat abnormal heart rhythms, most often those that cause abnormally fast heart rates. It is frequently used to treat heart disease in the boxer dog breed.

Its use in cats and dogs to treat abnormal heart rhythms is off label (extra label). Many drugs are commonly prescribed for off-label use in veterinary medicine.

“Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label. 

How is sotalol given?

• Sotalol is given by mouth in the form of a tablet or liquid solution. It can also be given by injection in the hospital.
• Measure liquid forms carefully.
• Give sotalol on an empty stomach, if possible, at least one hour before feeding or two hours after feeding.
• If vomiting occurs when given on an empty stomach, try giving future doses with a small amount of food. Contact your veterinarian if vomiting continues.

This medication should take effect within 1 to 2 hours; however, effects may not be noted outwardly, and laboratory tests may be needed to evaluate this medication’s effectiveness.

What if I miss giving my pet the medication?

If you miss a dose, give it as soon as you remember, and then wait the recommended time for the next dose, as prescribed by your veterinarian. Do not give the pet two doses at once.

Are there any potential side effects?

Sotalol may cause the following side effects:

• Tiredness
• Nausea
• Vomiting

Serious adverse reactions may occur. If any of the following signs develop, stop giving sotalol and contact your veterinarian immediately:

• Very slow heart rate
• Collapse
• Weakness
• Difficulty breathing
• Coughing
• Fainting
• Lack of appetite

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately.  This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE sotalol in pets that:

• Are allergic to it
• Have asthma
• Have heart block
• Have slow heart rate
• Have uncontrolled congestive heart failure
• Are in shock

USE WITH CAUTION in pets that:

• Have controlled congestive heart failure
• Have diabetes
• Have kidney disease
• Have hyperthyroidism
• Are pregnant (safety has not been established)
• Are lactating (consider using a milk replacer as this medication affects the milk)

Are there any drug interactions I should be aware of?

Several medications should be used with caution when given with sotalol, including:

• Amiodarone
• Antacids
• Antiarrhythmics (class 1A, 1B and 1C)
• Azithromycin
• Calcium channel blockers
• Cisapride
• Clarithromycin
• Clonidine
• Cyclobenzaprine
• Digoxin
• Diuretics
• Erythromycin
• Fluoroquinolones
• Fluoxetine
• Lidocaine
• Methimazole
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Phenothiazines
• Sympathomimetics
• Tricyclic antidepressants

This medication may cause low blood sugar, and may interact with glucose or insulin tolerance tests.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any treatment.

Is any monitoring needed with this medication?

• There is no specific monitoring that needs to be done while your pet is taking this medication.
• Your veterinarian may monitor your pet to be sure that the medication is working, which includes performing an electrocardiogram (ECG).
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store sotalol?

Store this medication at room temperature, 68°F to 72°F (20°C to 22°C).

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.