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Sotalol
Systematic (IUPAC) name
(RS)-N-{4-[1-hydroxy-2-(propan-2-ylamino)ethyl]phenyl}methanesulfonamide
Identifiers
CAS number 3930-20-9
ATC code C07AA07
PubChem 5253
DrugBank DB00489
Chemical data
Formula C 12H20N2O3S 
Mol. mass 272.3624 g/mol
Pharmacokinetic data
Bioavailability >95%
Metabolism Not metabolised
Half life 12 hours
Excretion Renal
Lactic (In lactating females)
Therapeutic considerations
Pregnancy cat. B(US)
Legal status Prescription only
Routes oral
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Sotalol (trade names Betapace and Betapace AF, Berlex Laboratories, Sotalex and Sotacor, Bristol-Myers Squibb) is a drug used in individuals with rhythm disturbances (cardiac arrhythmias) of the heart, and to treat hypertension in some individuals.

Sotalol is a non-selective beta blocker. It is also a potassium channel blocker and is therefore a class III anti-arrhythmic agent. Because of this dual-action, Sotalol prolongs both the PR interval and the QT interval.

Indications

Sotalol is used to treat ventricular tachycardias[1] as well as atrial fibrillation.[2] Betapace AF is specifically labeled for atrial fibrillation.

Some evidence suggests that sotalol should be avoided in the setting of decreased ejection fraction due to an increased risk of death.[3]

It has also been suggested that it be used in the prevention of atrial fibrillation.[4]

While on sotalol patients may resume any physical activities.

References

  1. ^ Boriani G, Lubinski A, Capucci A, et al. (December 2001). "A multicentre, double-blind randomized crossover comparative study on the efficacy and safety of dofetilide vs sotalol in patients with inducible sustained ventricular tachycardia and ischaemic heart disease". Eur. Heart J. 22 (23): 2180–91. doi:10.1053/euhj.2001.2679. PMID 11913480. http://eurheartj.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=11913480.  
  2. ^ Singh BN, Singh SN, Reda DJ, et al. (May 2005). "Amiodarone versus sotalol for atrial fibrillation". N. Engl. J. Med. 352 (18): 1861–72. doi:10.1056/NEJMoa041705. PMID 15872201. http://content.nejm.org/cgi/pmidlookup?view=short&pmid=15872201&promo=ONFLNS19.  
  3. ^ Waldo A, Camm A, deRuyter H, Friedman P, MacNeil D, Pauls J, Pitt B, Pratt C, Schwartz P, Veltri E (1996). "Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol". Lancet 348 (9019): 7–12. doi:10.1016/S0140-6736(96)02149-6. PMID 8691967.  
  4. ^ Patel A, Dunning J (April 2005). "Is Sotalol more effective than standard beta-blockers for the prophylaxis of atrial fibrillation during cardiac surgery". Interact Cardiovasc Thorac Surg 4 (2): 147–50. doi:10.1510/icvts.2004.102152. PMID 17670378. http://icvts.ctsnetjournals.org/cgi/pmidlookup?view=long&pmid=17670378.  
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