Sotalol
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied Health
• 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.1
• 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.2
• 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.3
• 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. Antacids4
• 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.5
• 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.66
References1 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 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.
2 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.
3 4. Rosa RM, Silva P, Young JB, et al. Adrenergic modulation of extrarenal potassium disposal. N Engl J Med 1980;302:431–4.
3 5. Lundborg P. The effect of adrenergic blockade on potassium concentrations in different conditions. Acta Med Scand Suppl 1983;672:121–6 [review
4 7. Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 741–5.
4 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.
5 9. . Laer S, Neumann J, Scholz H. Interaction between sotalol and an antacid preparation. Br J Clin Pharmacol 1997;43:269–72.
6 6. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213–4.
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Disclaimers
The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.
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