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Sotalol

 Herbs
 Interactions with Supplements
 Interactions with Herbs
 Other Interactions
 References


Alternative Medicine
The following information is specific for alternative and complementary medicine. For additional evidence-based information on diseases, conditions, symptoms, diagnosis, treatment and wellness issues, continue searching the Healthwise Knowledgebase.


Also indexed as:

Betapace



Sotalol is used to treat certain types of heart arrhythmia, and is in a family of drugs known as beta-adrenergic blockers.

Herbs

Summary of Interactions for Sotalol

Depletion or interferenceNone known
Adverse interactionHigh-potassium foods*
Pleurisy root*
Potassium (low)
Potassium supplements*
Side effect reduction/prevention Magnesium
Supportive interactionNone known
Reduced drug absorption/bioavailability Antacids
Calcium supplements
Food
Milk


An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Supplements

Calcium

One controlled study showed that taking sotalol with a calcium gluconate solution dramatically reduces the absorption of the drug.1 Consequently, people who take a calcium supplement should take sotalol an hour before or two hours after the calcium.

Magnesium

Two individuals taking sotalol developed a side effect of the drug (a heart arrhythmia known as torsades de pointes) which was effectively treated with intravenous magnesium.2, 3 Additional research is needed to determine whether people taking sotalol might be able to prevent this side effect by taking supplemental magnesium.

Potassium

People with prolonged diarrhea and vomiting, as well as those taking potassium-depleting diuretics, might develop low blood potassium levels. Individuals with low blood potassium levels who take sotalol have an increased risk of developing a serious heart arrhythmia and fainting. Therefore, people taking sotalol should have their blood potassium levels checked regularly and may need to supplement with potassium, especially when taking potassium-depleting diuretics.

Some beta-adrenergic blockers (called "nonselective" beta blockers) decrease the uptake of potassium from the blood into the cells,4 leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.5 People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.

Interactions with Herbs

Pleurisy root

As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides, it is best to avoid use of pleurisy root with heart medications such as beta-blockers.6

Other Interactions

Food

Taking sotalol with food gretly reduces the absorption of the drug.7 One study showed that taking sotalol with milk also decreases absorption.8 Therefore, sotalol should be taken an hour before or two hours after a meal or milk.

Antacids

Taking sotalol within two hours of antacids containing aluminum oxide and magnesium hydroxide dramatically reduces the absorption of the drug. Antacids that contain calcium carbonate might also reduce absorption.9 Consequently, if antacids are being used, sotalol should be taken one hour before or two hours after the antacids.

References

  1. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.
  2. Sasse M, Paul T, Bergmann P, Kallfelz HC. Sotalol associated torsades de pointes tachycardia in a 15-month-old child: successful therapy with magnesium aspartate. Pacing Clin Electrophysiol 1998;21:1164-6.
  3. Arstall MA, Hii JT, Lehman RG, Horowitz JD. Sotalol-induced torsade de pointes: management with magnesium infusion. Postgrad Med J 1992;68:289-90.
  4. Rosa RM, Silva P, Young JB, et al. Adrenergic modulation of extrarenal potassium disposal. N Engl J Med 1980;302:431-4.
  5. Lundborg P. The effect of adrenergic blockade on potassium concentrations in different conditions. Acta Med Scand Suppl 1983;672:121-6 [review].
  6. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213-4.
  7. Sifton DW, ed. Physicians' Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 741-5.
  8. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7-12.
  9. Laer S, Neumann J, Scholz H. Interaction between sotalol and an antacid preparation. Br J Clin Pharmacol 1997;43:269-72.

Last Review: 09-07-2006

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires August 2007.



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