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| Interactions: | Adrenaline
Adverse Effect: Hypertension, bradycardia, resistance to Adrenaline in anaphylaxis Clinical Management: Concurrent use should be avoided if possible. However, if used concurrently, monitor blood pressure carefully. If a nonselective Sotalol causes resistance to Adrenaline in anaphylactic shock, glucagon may be effective in a dose of 1 mg or more intravenously every five minutes.
Amiodarone
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Amiodarone is not recommended. The Amiodarone should be withheld for at least three half-lives prior to dosing with sotalol.
Amitriptyline
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Amitriptyline is not recommended.
Amoxapine
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Amoxapine is not recommended.
Antacids Comb.
Adverse Effect: Decreased sotalol serum concentrations and efficacy Clinical Management: Antacids should be administered at least two hours after sotalol dosing.
Astemizole
Adverse Effect: an increased risk of QT prolongation and ventricular arrhythmias Clinical Management: Concomitant therapy with astemizole and sotalol should be undertaken with caution. Monitor patients closely for changes in the ECG.
Bupivacaine Comb.
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and a phenothiazine is not recommended
Celecoxib
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Chlordiazepoxide
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Chlordiazepoxide is not recommended.
Cisapride
Adverse Effect: cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent use of cisapride and Sotalol is contraindicated.
Clomipramine
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Clomipramine is not recommended.
Clonidine
Adverse Effect: exaggerated clonidine withdrawal response (acute hypertension) Clinical Management: Patients to be withdrawn from clonidine who are concomitantly receiving a beta blocking agent should be monitored carefully for hypertension. Withdraw the beta blocker several days before a gradual lowering of clonidine doses. Alternatively, substitute labetalol (an alpha/beta blocker) for clonidine. Labetalol (800 to 1200 mg) should be titrated to individual patient needs based on blood pressure monitoring. In case of hypertensive crisis, alpha adrenergic blocking agents, such as phentolamine and prazosin, may be used.
Digoxin
Adverse Effect: AV block and possible digoxin toxicity Clinical Management: When beta blockers and digoxin are to be given concomitantly, carefully monitor ECG and digoxin serum concentrations. Adjust doses accordingly.
Diltiazem
Adverse Effect: Hypotension, bradycardia, AV conduction disturbances Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure. A dosage adjustment for hepatically metabolized beta blockers may be required.
Disopyramide
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Disopyramide is not recommended. The Disopyramide should be withheld for at least three half-lives prior to dosing with sotalol.
Dothiepin
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Dothiepin is not recommended.
Doxepin
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Doxepin is not recommended.
Fentanyl
Adverse Effect: Severe hypotension Clinical Management: Concurrent use of a calcium channel blocker and a beta-adrenergic blocker during fentanyl anesthesia has been reported to result in severe hypotension.
Flunarizine
Adverse Effect: Hypotension, bradycardia, and AV conduction disturbances Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure or bradyarrhythmias.
Fluphenazine
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and a phenothiazine is not recommended.
Flurbiprofen
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ibuprofen
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ibuprofen Comb.
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Imipramine
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Imipramine is not recommended.
Indomethacin
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ketoprofen
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Ketorolac
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Lidoflazine
Adverse Effect: Hypotension, bradycardia, and AV conduction disturbances Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure or bradyarrhythmias.
Mefenamic Acid
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Meloxicam
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Methyldopa
Adverse Effect: Exaggerated hypertensive response, tachycardia, or arrhythmias during physical stress or exposure to exogenous catecholamines Clinical Management: Monitor blood pressure carefully during concurrent therapy, especially during excessive physiologic stress or use of exogenous catecholamines such as phenylpropanolamine.
Nabumetone
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Naproxen
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Nimesulide
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Nortriptyline
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest)
Oxyphenbutazone
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Paracetamol
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Paracetamol Comb.
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Phenacetin
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Phenylbutazone
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Pimozide
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: Pimozide is contraindicated in individuals with congenital QT syndrome, patients with a history of cardiac arrhythmias, or patients taking other drugs which may prolong the QT interval.
Piroxicam
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Prazosin - BPH
Adverse Effect: An exaggerated hypotensive response to the first dose of the alpha blocker Clinical Management: When concurrent therapy with an alpha blocker and a beta blocker is required, initiate the alpha blocker with a smaller than usual dose, preferably at bedtime. Monitor the patient closely for hypotension.
Procainamide
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Procainamide is not recommended. The Procainamide should be withheld for at least three half-lives prior to dosing
Quinidine
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Quinidine is not recommended. The Quinidine should be withheld for at least three half-lives prior to dosing with sotalol.
Ritodrine
Adverse Effect: Potential interference with tocolytic action of ritodrine Clinical Management: It is possible to successfully treat a patient with both a beta blocker and a beta mimetic if an appropriate dosage is found and the clinical response is monitored.
Sparfloxacin
Adverse Effect: prolongation of the QTc interval and/or torsades de pointes Clinical Management: Sparfloxacin is contraindicated in individuals with known QTc prolongation or in patients being treated concurrently with drugs that are known to increase the QTc interval and/or cause torsades de pointes.
Tenoxicam
Adverse Effect: Decreased antihypertensive effect Clinical Management: If concurrent therapy is required, monitor the patients blood pressure carefully and assess the need for a dosage adjustment for the beta blocker.
Terazosin - BPH
Adverse Effect: An exaggerated hypotensive response to the first dose of the alpha blocker Clinical Management: When concurrent therapy with an alpha blocker and a beta blocker is required, initiate the alpha blocker with a smaller than usual dose, preferably at bedtime. Monitor the patient closely for hypotension.
Terfenadine
Adverse Effect: ventricular arrhythmias Clinical Management: Concurrent use of sotalol and terfenadine is not recommended because both drugs are known to prolong the QT interval.
Thioridazine
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and a phenothiazine is not recommended.
Trifluoperazine
Adverse Effect: Increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and a Trifluoperazine is not recommended.
Trimipramine
Adverse Effect: an increased risk of cardiotoxicity (QT prolongation, torsades de pointes, cardiac arrest) Clinical Management: The concurrent administration of sotalol and Trimipramine is not recommended.
Verapamil
Adverse Effect: Hypotension, bradycardia Clinical Management: If concurrent therapy is required, monitor cardiac function carefully, particularly in patients predisposed to heart failure. |
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