Alternate Name(s):
Apo-sotalol
Classification:
Antiarrhythmic
Original Date:
February 2009
Revised Date:
February 2021
Indications:
- Treatment of ventricular and supraventricular tachyarrhythmias
Administration:
- PO
Dosage:
- 2 - 5 mg/kg/day divided Q8h
- Allow 2-3 days between dosage increments to achieve new steady-state and to monitor clinical response, heart rate and QTc intervals
Dosage adjustment required in renal impairment. Refer to available references or clinical pharmacist for dosage adjustment.
Side Effects:
- CVS: bradycardia, proarrhythmias (SA block, AV block, Torsades de pointes), prolongation of QTc interval, hypotension
- Dermatologic: rash
- Endocrine and metabolic: hypoglycemia predominantly in type-1 diabetics
- Respiratory: dyspnea
Parameters to Monitor:
- Daily ECG for 3 days at inititation, and until stable dosing achieved to measure QTc. Monitor heart rate, blood pressure, renal function, serum potassium and magnesium
- Serum glucose: consider blood glucose monitoring q6h for the first 24-48 hours following initiation/dose titration. Blood glucose ac feeds and/or 1-2 hours post-dose.
Reconstitution and Stability:
N/A
Compatibility:
N/A
References:
- Lau E. (Editor). Drug Handbook and Formulary - The Hospital for Sick Children 2020 Toronto: lexi-Comp Inc; 2020
- Taketomo CK, Hodding JH, Kraus DM. Pediatric & Neonatal Dosage Handbook 22nd edition. Hudson: Lexi-Comp Inc: 2015
- Läer S, Elshoff JP, Meibohm B, Weil J, Zhang W, Hulpke-Wette M, Development of a Safe and Effective Pediatric Dosing Regimen for Sotalol Based on Population Pharmacokinetics and Pharmacodynamics in Children with Supraventicular Tachycardia. J Am Coll Cardiol. 2005; 46: 1322-1330