Note that these doses were given twice or once daily, depending on renal function. Sotalol and sotalol …
In patients with frequent premature ventricular complexes (VPC), Sotalol hydrochloride was significantly superior to placebo in reducing VPCs, paired VPCs and non-sustained ventricular tachycardia (NSVT); the response was dose-related through 640 mg/day with 80–85% of patients having at least a 75% reduction of VPCs. Factors such as reduced creatinine clearance, female sex, higher doses, reduced heart rate and history of sustained VT/VF or heart failure increase the risk of TdP. Aqua-Cen Oral, Aquamet Oral, Aquazide-H Oral, Carozide Oral, Diaqua Oral, Diurazide Oral, Esidrix Oral, Ezide Oral, Hyazide Oral, Hychlor Oral, Hyclar 25 Oral, Hyclar 50 Oral, Hydoril Oral, Hydroaca Oral, Hydroben Oral, Hydro-Chlor Oral, Hydrochlorulan Oral, Hydro-D Oral, HydroDiuril Oral, … The results are shown in Figure 2, Discontinuation because of adverse events was dose related. Animal reproductive studies are not always predictive of human response.Reproduction studies in rats and rabbits during organogenesis at 9 and 7 times the MRHD (based on surface area), respectively, did not reveal any teratogenic potential associated with Sotalol.
This dose may be increased in increments of 80 mg per day every 3 days provided the QTc <500 msec The recommended initial dose is 80 mg twice daily. Incidence of discontinuation for these adverse reactions was dose related.One case of peripheral neuropathy that resolved on discontinuation of Sotalol hydrochloride and recurred when the patient was rechallenged with the drug was reported in an early dose tolerance study.In an unblinded multicenter trial of 25 pediatric patients with SVT and/or VT receiving daily doses of 30, 90 and 210 mg/mIn a pooled clinical trial population consisting of 4 placebo-controlled studies with 275 patients with atrial fibrillation (AFIB)/atrial flutter (AFL) treated with 160 to 320 mg doses of Sotalol hydrochloride (AF), the following adverse reactions presented in Overall, discontinuation because of unacceptable adverse events was necessary in 17% of the patients, and occurred in 10% of patients less than two weeks after starting treatment. If the QT interval increased to ≥520 msec (or JT ≥430 msec if QRS >100 msec) the drug was discontinued.
Among responders placed on long-term therapy identified acutely as effective (by either PES or Holter), Sotalol, when compared to the pool of other drugs, had the lowest two- year mortality (13% vs. 22%), the lowest two-year VT recurrence rate (30% vs. 60%), and the lowest withdrawal rate (38% vs. about 75–80%). Sotalol belongs to the classes of medications called antiarrhythmics and beta-blockers. You may experience headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate. If Sotalol is to be administered, use the smallest effective dose, to minimize inhibition of bronchodilation produced by endogenous or exogenous catecholamine stimulation of beta 2 receptors.Beta blockers may mask tachycardia occurring with hypoglycemia, but other manifestations such as dizziness and sweating may not be significantly affected. Sotalol hydrochloride is a white, crystalline solid with a molecular weight of 308.8. As well, some forms of this medication may not be used for all of the conditions discuss… One patient was discontinued because of worsening congestive heart failure. In cases of massive intentional overdosage (2–16 grams) of Sotalol the following clinical findings were seen: hypotension, bradycardia, cardiac asystole, prolongation of QT interval, Torsade de Pointes, ventricular tachycardia, and premature ventricular complexes. Sotalol hydrochloride did not produce a significant increase in survival (7.3% mortality on Sotalol hydrochloride vs. 8.9% on placebo, p=0.3), but overall did not suggest an adverse effect on survival. The patient population in this trial was 64% male, and the mean age was 62 years. Concomitant use can increase the risk of bradycardia.Sotalol and calcium-blocking drugs can be expected to have additive effects on atrioventricular conduction or ventricular function. In patients with life-threatening arrhythmias [sustained ventricular tachycardia/fibrillation (VT/VF)], Sotalol hydrochloride was studied acutely [by suppression of programmed electrical stimulation (PES) induced VT and by suppression of Holter monitor evidence of sustained VT] and, in acute responders, chronically.In a double-blind, randomized comparison of Sotalol and procainamide given intravenously (total of 2 mg/kg Sotalol vs. 19 mg/kg of procainamide over 90 minutes), Sotalol suppressed PES induction in 30% of patients vs. 20% for procainamide (p=0.2).In a randomized clinical trial [Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) Trial] comparing choice of antiarrhythmic therapy by PES suppression vs. Holter monitor selection (in each case followed by treadmill exercise testing) in patients with a history of sustained VT/VF who were also inducible by PES, the effectiveness acutely and chronically of Sotalol hydrochloride was compared with that of 6 other drugs (procainamide, quinidine, mexiletine, propafenone, imipramine and pirmenol). Continually monitor patients with each uptitration in dose, until they reach steady state.
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