Active Ingredients

Sotalol – Effect, Application & Risks


Sotalol is a pharmacological agent that belongs to the category of beta -blockers . The drug is primarily used to treat cardiac arrhythmias . Sotalol is a special beta blocker that does not have a phenol ether structure. The structure of the substance is also similar to that of beta-isoprenaline.

What is sotalol?

The drug sotalol is one of those beta blockers that are non-selective. This is because the active ingredient is not tied to specific binding to the beta-1 adrenoceptors. Unlike the drugs oxprenolol and acebutolol , it has no so-called sympathomimetic activity.

Basically, the substance sotalol occurs in the form of a racemate. Thus, potassium channels are blocked. In addition, the drug sotalol has an L-form, which is why it is effective as a beta-blocker. The drug also has a so-called enantiomeric unit, which influences the effectiveness of the substance.

Pharmacological action

Basically, the drug sotalol causes the potassium channels to close. For this reason, the drug sotalol is one of the third class antiarrhythmics . The active ingredient prolongs the refractory period and the action potential . In addition, special beta-1 receptors inside the heart are also blocked. As a result, the conduction speed and the contractility of the heart muscle are reduced .

In addition, the frequency of the heart and the excitability of the heart are reduced. In addition, there is an inhibition of the sympathetic system and reinsecretion. This lowers the patient ‘s blood pressure over the long term .

All third class antiarrhythmics are characterized by the fact that they block the potassium channels. The active ingredient sotalol slows down the potassium flow in particular, which is responsible for repolarization . Special electrophysiological measurement methods have shown that the action potential of the isolated heart muscle cells is lengthened. As a result, the refractory period of the heart muscle cells also increases . The inhibition of the potassium channels is primarily responsible for this.

The bioavailability of the active ingredient sotalol is almost one hundred percent. However, no binding to plasma proteins can be detected. Basically, the control options of the drug are rather limited, since the plasma half-life is around 15 hours.

The drug is primarily excreted via the kidneys. For this reason, an adjustment of the dose is absolutely necessary in patients with existing renal insufficiency. Due to its extremely long plasma half-life, the drug sotalol is one of the beta-blockers with the longest duration of action.

Medical Application & Use

The drug Sotalol is primarily used in the treatment of various cardiac arrhythmias. The drug is therefore a so-called antiarrhythmic.

Possible areas of application for the active substance are, for example , coronary heart diseases , cardiac arrhythmias and arterial hypertension . Because the drug is also able to lower blood pressure.

Risks & side effects

Sotalol is characterized by a number of possible undesirable side effects that must be considered before administering the drug. In particular, the blockade of the potassium channels means that the drug triggers special side effects in some cases. This also distinguishes sotalol from numerous other beta blockers. It is particularly characteristic that the substance sotalol itself can lead to cardiac arrhythmias. Torsade de pointes tachycardia is a particularly dangerous complication. It sometimes triggers ventricular fibrillation , which in some cases results in immediate cardiac death . Such side effects are particularly evident in kidney failure, high-dose intake andElectrolyte imbalances .

The so-called long QT syndrome also sometimes promotes similar side effects. Medical research has shown that women are three times more likely than men to suffer from torsades de pointes tachycardia while taking sotalol. For this reason, administration of the drug sotalol should be avoided if the QT interval is prolonged.

The active ingredient sotalol is also contraindicated for some other complaints. These include, for example, sinus bradycardia and asthma attacks . A so-called bronchoconstriction is possible because the drug sotalol activates the beta-2 receptors. Avoiding sotalol is also recommended in the case of AV conduction disorders. Finally, there is a risk of hypoglycemia , particularly in patients with diabetes , due to the inhibition of glycogenolysis as a result of blocked beta-2 receptors .

Other contraindications are, for example, pregnancy and breastfeeding . Because the active ingredient sotalol passes into breast milk . Basically, the undesirable side effects and symptoms of the drug Sotalol occur with different frequencies. In addition, depending on the individual case and person, they differ in their characteristics, their degree of severity and the combination of various side effects. Some patients who are treated with the drug sotalol do not suffer from any undesirable side effects. Other people are affected by mild to severe symptoms.

It is therefore particularly important to carefully weigh up the individual risk factors of the patient in question, such as existing kidney weakness, before taking the drug Sotalol for the first time. In the course of this, the attending doctor discusses the personal medical history of the patient in order to keep the risk of serious complications while taking the drug as low as possible. In addition, it is the patient’s responsibility to contact a doctor immediately if symptoms arise. It may be necessary to discontinue sotalol and find an alternative treatment option.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.