Sotalol, also known as Betapace can be a wonderful drug. It can help lower your heart rate, help with your blood pressure, help to prevent heart attacks, and keep you from having an arrhythmia. But what you don’t know can kill you. While used in a proper setting under a physicians care, Sotalol can be a life saver but without the proper monitoring and use you can be in a world of trouble. As a cardiac nurse with close to 15 years of experience, I am writing this article to give you the information you need to make sure this therapy is as good as it can be. As usual, however, I am not your nurse and the information I give is from my personal experiences, knowledge and use of this medication. Always consult with your doctor or pharmacist if you have any questions regarding your health or medications.
Sotalol is what is known as a beta blocker. Simply put it blocks certain hormones in your body that regulate your heart rate and blood pressure. While this can be a good thing, there are certain side effects of this medication that you need to be aware of. I will be describing several of these as we go along.
The first thing you need to know is that this drug is excreted by your kidneys. So if you have kidney disease you should be on a timing schedule that is based upon how well your kidneys are functioning. Your doctor can find this out by doing a test called creatinine clearance. This test is done on blood and urine and will help your doctor know how frequently you should use this drug. If you are unsure if you have any kidney disease, be sure to ask your doctor if he has checked this important test.
One of the most serious complications that can come from using this drug is called torsades de pointes. This is an arrhythmia. Like all other beta blockers not only can they stop arrhythmia’s but they can cause them as well. This arrhythmia can be caused by what is known a long QT. Simply put this is an elongation of a part of the electrical current that causes your heart to beat. It is very important that your doctor has a baseline EKG as well as monitors your EKG closely when you start this drug. Ideally you should be hospitalized for about 3 days when you start this drug. Another factor that can contribute to this arrhythmia is a low potassium level so make sure you doctor has checked this level as well. While this arrhythmia can be fatal, it can usually be fixed quite easily if it is caught quickly. This is one of the main reasons you should be in the hospital when starting this drug.
Another complication is congestive heart failure. While I will not go into detail regarding this disease, It is basically an inability of your heart to pump blood effectively throughout the body resulting in a fluid buildup. This is managed very well by a competent physician with medication and lifestyle changes.
A third potential complication that can result of this drug is related to your lungs. If you have emphysema or chronic bronchitis you should generally not use this drug. I have seen it used in some cases with these types of patients but that is something that needs to be discussed closely with your doctor and you need to monitored very closely.
Another potential for trouble is if you are diabetic. If you are not sure or even if you think you are not diabetic ask your doctor to check. While the risk is low, this drug can mask some of the signs we see with hypoglycemia(low blood sugar).
Finally make sure that your doctor knows all of the medications you are taking at home. I know this is something you hear all the time but it is extremely important as this drug can interact with several other drugs. Some of the drugs you need to be aware of are: Amioderone an antiarrhythmic, Insulin or other diabetic drugs, antacids that contain magnesium hydroxide or aluminum oxide such as milk of magnesia or alka seltzer. Some antibiotics and depression medications can cause issues as well. While this list is not conclusive by any means these are some of the more common drugs. Be sure that your doctor knows.
Some other common but rather just inconveniencing side effects related to this drug include: nausea, vomiting, diarrhea, stomach pain, back pain, extremity pain, rash, headache and dizziness. If you experience these let your doctor know but if it is tolerable it is important to keep using this drug if you can.
While these side effects and potential complications is not an all inclusive list, it does convey the majority of the serious complications. It also lists the most common non serious side effects. As always you and your doctor must determine if this therapy is right for you. I hope that this knowledge will help you in your quest for good health.
