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Class III antiarrhythmic + non-selective β-blocker

Sotalol hydrochloride

Brand names: Beta-Cardone, Sotacor

Sotalol hydrochloride is a non-selective beta-blocker with additional class III antiarrhythmic action, used principally to maintain sinus rhythm in atrial and life-threatening ventricular arrhythmias.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It combines non-selective beta-adrenoceptor blockade with potassium-channel blockade that prolongs cardiac repolarisation and the action potential, increasing the refractory period.

Prescribing in practice

  • Sotalol prolongs the QT interval and can provoke torsades de pointes, so correct hypokalaemia and hypomagnesaemia, avoid other QT-prolonging drugs, and follow recommended ECG-guided initiation as in the SPC.
  • It is renally cleared and accumulates in renal impairment, requiring dose reduction and greater caution.
  • Standard beta-blocker contraindications apply, including asthma, uncontrolled heart failure, marked bradycardia and high-grade heart block.

Monitoring

Monitor the ECG (especially QT interval and heart rate), serum electrolytes and renal function at initiation, after dose changes and during maintenance.

Counselling the patient

  • Do not stop the drug abruptly, as this can worsen arrhythmias.
  • Report palpitations, fainting or dizziness urgently.
  • Attend for the ECG and blood tests needed to use this medicine safely.

Evidence & guidelines

Sotalol's QT-prolonging, pro-arrhythmic profile is well established, and guidance such as that from NICE and the MHRA stresses ECG and electrolyte monitoring during use.

Reference: NICE NG196; ESC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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