Class III antiarrhythmic + non-selective β-blocker
Sotalol hydrochloride
Brand names: Beta-Cardone, Sotacor
Adult dose
Dose: AF/SVT: 80mg PO BD initially, increase to 160–320mg/day in 2 divided doses
Route: PO
Frequency: BD
Dose adjustments
Renal
Reduce frequency in renal impairment (BD → OD if CrCl 30–60; alt-day if <30)
Clinical pearls
- AF rhythm control, SVT — initiation usually inpatient with ECG/electrolyte monitoring
- Discontinue if QTc >500ms
Contraindications
- Asthma
- Long QT syndrome
- Severe bradycardia
- 2nd/3rd-degree AV block
- Cardiogenic shock
- Hypokalaemia/hypomagnesaemia
Side effects
- Bradycardia
- Torsades de pointes (dose-related QT prolongation)
- Bronchospasm
- HF exacerbation
- Fatigue
- Cold extremities
Interactions
- QT-prolonging drugs (avoid)
- Class I/III antiarrhythmics
- Hypokalaemia-inducing drugs
Monitoring
- ECG (QTc)
- K+
- Mg2+
- HR
Reference: BNF; NICE NG196; ESC; https://bnf.nice.org.uk/drugs/sotalol-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- NYHA Heart Failure Classification · Heart Failure
- GRACE ACS Risk Score · Acute Coronary Syndrome
- MAGGIC Heart Failure Risk Score · Heart Failure
- WHO Functional Classification (Pulmonary Hypertension) · Pulmonary Hypertension
- Long QT Syndrome (Schwartz Score) · Channelopathy / Sudden Cardiac Death
- C-Peptide to Glucose Ratio · Diabetes Classification
Pathways
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines