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Pharmacology of Sotalol; Definition, Mechanism of action, Pharmacokinetics, Uses, Effect
Sotalol is a unique medication that combines two powerful actions: it's both a non-selective beta-blocker and a Class III antiarrhythmic agent. That means it slows the heart rate and helps stabilize abnormal heart rhythms—especially in conditions like atrial fibrillation, atrial flutter, and ventricular tachycardia2.
💊 Pharmacology Snapshot
Feature Details
Drug Class Beta-blocker + Class III antiarrhythmic
Mechanism Blocks β1 & β2 receptors; prolongs cardiac repolarization by inhibiting potassium channels
Bioavailability ~90–100% orally
Half-life ~12 hours
Excretion Primarily via kidneys
🩺 Clinical Uses
Maintains normal rhythm in atrial fibrillation/flutter
Treats life-threatening ventricular arrhythmias
Sometimes used off-label for essential tremor or migraine prevention
It’s typically reserved for patients with symptomatic or high-risk arrhythmias, due to its potential for serious side effects2.
⚠️ Side Effects & Risks
Common Serious
Fatigue, dizziness, nausea QT prolongation, torsades de pointes, bradycardia, heart failure2
QT prolongation is a major concern—it can lead to dangerous arrhythmias like torsades de pointes
Requires hospital monitoring for at least 3 days when starting or restarting therapy
🚫 Contraindications
Asthma or COPD
Severe heart failure
Long QT syndrome
Bradycardia or AV block (unless pacemaker is present)
Low potassium or magnesium levels
Severe kidney disease
🧪 Monitoring & Administration
Initiated in a hospital setting with ECG monitoring
Dosage adjusted based on renal function and QT interval
Available as oral tablets, oral solution, and IV infusion
#Sotalol
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