Empire Plan Flexible Formulary. • Raynaud's phenomenon and severe peripheral circulatory disturbances; Sotalol should not be used where there is evidence of: Due to the multiple risk factors associated with torsades de pointes, however, caution should be exercised regardless of the QTc-interval.Careful monitoring and dose titration are critical during initiation and followupOf therapy. 0000000760 00000 n Hey - your image changed drasitcally since I opened this message thread! Suprax may also be used for purposes not listed in this medication guide. 0000003399 00000 n Like other beta adrenergic blocking agents, sotalol produces a gradual but significant reduction in both systolic and diastolic blood pressures in hypertensive patients. Copyright © 2018 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. It allows continued monitoring of the benefit/risk balance of the medicinal product. After oral administration, peak levels are reached in 2.5 to 4 hours, and steady-state plasma levels are attained within 2-3 days. Over the dosage range 40-640 mg/day sotalol displays dose proportionality with respect to plasma levels. This site uses cookies. Its major effects are prolongation of the atrial, ventricular and accessory pathway effective refractory periods.The Class II and III properties may be reflected on the surface electrocardiogram by a lengthening of the PR, QT and QTc (QT corrected for heart rate) intervals with no significant alteration in the QRS duration.The d- and l-isomers of sotalol have similar Class III antiarrhythmic effects while the l-isomer is responsible for virtually all of the beta-blocking activity. For excipients see 6.1. Round, white to off-white, flat bevelled edged tablets with break line on one side. apparent increase in mortality) suggest that Sotacor should be avoided in patients with left ventricular ejection fractions ≤40% without serious ventricular arrhythmias. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.Things to remember when you fill your prescription.WebMD does not provide medical advice, diagnosis or treatment. The molecule exists as a zwitterion at the pH conditions in the small intestine. 28 0 obj << /Linearized 1 /O 30 /H [ 760 187 ] /L 24020 /E 6228 /N 9 /T 23342 >> endobj xref 28 17 0000000016 00000 n Although there are no adequate and well-controlled studies in pregnant women, sotalol hydrochloride has been shown to cross the placenta and is found in amniotic fluid. Proarrhythmic events can occur not only at initiation of therapy, but also with each upward dosage adjustment.In view of its β-adrenergic blocking properties, treatment with sotalol should not be discontinued suddenly, especially in patients with ischaemic heart disease (angina pectoris, prior acute myocardial infarction) or hypertension, to prevent exacerbation of the disease (see Section 4.4 Special warnings and special precautions for use).The initial dose is 80 mg, administered either singly or as two divided doses.Oral dosage of sotalol should be adjusted gradually allowing 2-3 days between dosing increments in order to attain steady-state, and to allow monitoring of QT intervals. These include dyspnoea, fatigue, dizziness, headache, fever, excessive bradycardia and/orhypotension. Distribution occurs to a central (plasma) and a peripheral compartment, with an elimination half-life of 10-20 hours. Initiating therapy at 80 mg with gradual upward dose titration thereafter reduces the risk of proarrhythmia. In a large controlled trial in patients with a recent myocardial infarction without heart failure, who did not necessarily have ventricular arrhythmias, oral sotalol HCl treatment was associated with a nonstatistically significant risk reduction in mortality compared to the placebo group (18%). Most patients respond to a daily dose of 160 to 320 mg administered in two divided doses at approximately 12 hour intervals. Monographs cover generic and brand name, drug class and … 0000005278 00000 n Suprax is a cephalosporin (SEF a low spor in) antibiotic. 0000002063 00000 n Suprax is used to treat many different types of infections caused by bacteria. Sotalol does not bind to plasma proteins and is not metabolised.