Sotalol

Sotalol is not suitable for some people. For example, check with your doctor if you have low blood pressure, heart disease or kidney problems.

Sotalol comes as tablets that you usually take once or twice a day. Follow the instructions that come with your medicine.

Common side effects of sotalol include headaches and feeling tired, dizzy or weak. More serious side effects can happen in rare cases.

It can cause problems to take sotalol with some other medicines, such as medicines for high blood pressure, asthma or diabetes.

Most adults and children aged 12 years old and over can take sotalol.

It can also be taken by children under 12 years old on the advice of their specialist.

Sotalol is not suitable for some people.

To make sure it's safe for you, tell your doctor before starting to take it if you have:

• ever had an allergic reaction to sotalol or any other medicine
• low blood pressure or a slow heart rate
• heart failure which is getting worse, heart disease, or you've recently had a heart attack
• any problems with your kidneys
• an overactive thyroid (hyperthyroidism) – sotalol may make it more difficult to recognise the warning signs of having too much thyroid hormone in your body (thyrotoxicosis)
• severe blood circulation problems in your limbs (such as Raynaud's), which may make your fingers and toes tingle or turn pale or blue (this may be less noticeable if you have black or brown skin)
• metabolic acidosis – when there is too much acid in your blood
• a lung disease or severe asthma
• severe diarrhoea

Sotalol tablets come in different strengths: 40mg, 80mg and 160mg.

The usual dose of sotalol is between 80mg and 320mg a day. If you get irregular heartbeats several times a day, your doctor may prescribe a higher daily dose of up to 640mg.

If you're older or have kidney problems, your doctor may prescribe a lower dose.

How to take it

You can take sotalol with or without food, but it's best to take it the same way each day.

Swallow the tablets whole with a drink of water.

You'll usually take sotalol once or twice a day.

Your doctor may advise you to take your first dose before bedtime, because it can make you feel dizzy. After the first dose, if you do not feel dizzy, you can take sotalol in the morning.

If you take sotalol twice a day, try to take it in the morning and in the evening.

These common side effects of sotalol happen in more than 1 in 100 people. They're usually mild and do not last long. There are things you can do to help cope with them:

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller.

Headaches usually go away as your body gets used to the medicine. Talk to your doctor if the headaches do not go away or are severe.

If sotalol makes you feel dizzy or weak, stop what you're doing and sit or lie down until you feel better. Do not drive, ride a bike or use tools or machinery if you're feeling tired. Do not drink alcohol as it will make you feel worse.

Put your hands or feet under warm running water, massage them and wiggle your fingers and toes.

Do not smoke or have drinks with caffeine in, as these can make your blood vessels narrower and restrict your blood flow. Smoking also makes your skin colder.

Try wearing mittens (they're warmer than gloves) and warm socks. Do not wear tight watches or bracelets.

Stick to simple meals and do not eat rich or spicy food. It might help to take your sotalol after you've eaten.

If you're being sick, try small frequent sips of water to avoid dehydration. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or the progestogen-only pill and you're being sick, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.

Drink lots of fluids, such as water or squash, to avoid dehydration. Speak to a pharmacist if you have signs of dehydration such as peeing less than usual or having dark, strong-smelling pee.

Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take the combined contraceptive pill or the progestogen-only pill and you have severe watery diarrhoea, or any diarrhoea that lasts for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Speak to a doctor or pharmacist if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Sotalol can be taken in pregnancy, particularly if you have problems with your heart.

However, always check with your doctor that they're happy for you to keep taking it. They may wish to review your medicine and may recommend other medicines instead.

If you do take sotalol in pregnancy then you may need extra scans to check that your baby is growing at a normal rate.

If your baby is healthy, you may be able to take sotalol if you need to while you're breastfeeding. Talk to your doctor or pharmacist first, and they'll help you to decide.

There is not much information about taking sotalol while breastfeeding, but it shows sotalol can pass into breast milk in fairly high amounts compared to most medicines. This may increase the risk of your baby getting side effects.

However, sotalol has not been known to cause any side effects in breastfed babies from the information that's available.

It's important to keep taking sotalol to keep you well. Breastfeeding will also benefit both you and your baby.

It's very rare for breastfed babies to have side effects from medicines you're taking. But it's important to keep monitoring your baby if you're taking any medicine while breastfeeding.

Contact your healthcare professional or call 111 as soon as possible if your baby:

• is not feeding as well as usual, or not putting on weight as you would expect
• has diarrhoea or is being sick (vomiting)
• looks paler than usual
• gets a rash
• is behaving differently, for example being irritable
• is unusually sleepy

If your baby has any symptoms that are not listed, or if you're worried about them, you can also call 111 or contact any healthcare professional.

Keep breastfeeding as usual until you've got advice about your baby's symptoms.

There are some medicines that may affect the way sotalol works.

Tell your doctor if you're taking any other medicines, including:

• medicines that can cause abnormal heart rhythms – these include some antibiotics, like clarithromycin and erythromycin, and some antidepressants, like citalopram and amitriptyline
• other medicines used to treat an irregular heartbeat, such as amiodarone
• medicines for high blood pressure, such as diltiazem or verapamil
• medicines that can lower your potassium levels – these include medicines that remove extra fluid from your body, like furosemide, and some steroids, like prednisolone
• medicines for asthma or chronic obstructive pulmonary disease (COPD)
• medicines for diabetes, including metformin or insulin
• medicines for allergies, such as ephedrine, noradrenaline or adrenaline

These are not all the medicines that may cause problems if you take them with sotalol. For a full list, see the leaflet inside your medicine packet.