By Rania Gollakner, BS, DVM, MPH

What is sotalol?

Sotalol (brand names: Betapace®, Sorine®, Sotylize®, Sotamol®, Sotacor®, Rylosol®, Linsotalol®) is a beta-adrenergic blocker used to treat abnormal heart rhythms, most often those that cause abnormally fast heart rates. It is frequently used to treat Boxer Dogs with heart disease.

Its use in cats and dogs to treat abnormal heart rhythms is ‘off label’ or ‘extra label’. Many drugs are commonly prescribed for off label use in veterinary medicine. In these instances, follow your veterinarian’s directions and cautions very carefully as their directions may be significantly different from those on the label.

How is sotalol given?

Sotalol is given by mouth in the form of a tablet or liquid solution. It can also be given by injection in the hospital setting. Measure liquid forms carefully. Give sotalol on an empty stomach if possible, at least one hour before feeding or two hours after feeding. If vomiting occurs when given on an empty stomach, try giving future doses with a small amount of food; contact your veterinarian if vomiting continues.

This medication should take effect within 1 to 2 hours; however, effects may not be visibly noticeable and therefore laboratory tests may need to be done to evaluate this medication’s effectiveness.

What if I miss giving my pet the medication?

Give the missed dose as soon as you remember, and then wait the recommended amount of time between doses. Never give your pet two doses at once or give extra doses.

Are there any potential side effects?

The most common side effect is tiredness. Rare, but not serious side effects include nausea and vomiting. More serious side effects include a very slow heart rate, collapse, weakness, difficulty breathing, coughing, fainting, or lack of appetite.

This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

Sotalol should not be used in pets that are allergic to it or that have asthma, heart block, slow heart rate, uncontrolled congestive heart failure, or shock. It should be used cautiously in pets with controlled congestive heart failure, diabetes, kidney disease, or hyperthyroidism. Sotalol should be used with caution in pregnant pets as safety has not been established. If using in lactating pets, use cautiously and consider a milk replacer as this medication does affect the milk.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with sotalol: amiodarone, general anesthetics, antacids, antiarrhythmics (class 1A, 1B and 1C), azithromycin, calcium channel blockers, cisapride, clarithromycin, clonidine, cyclobenzaprine, digoxin, diuretics, erythromycin, fluoroquinolones, fluoxetine, lidocaine, methimazole, nonsteroidal anti-inflammatory drugs (NSAIDs), phenothiazines, reserpine, sympathomimetics, or tricyclic antidepressants.

This medication may cause low blood sugar and therefore may interact with glucose or insulin tolerance tests.

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking.

Is there any monitoring that needs to be done with this medication?

There is no specific monitoring that needs to be done while your pet is taking this medication. Your veterinarian may monitor your pet to be sure that the medication is working which includes performing an electrocardiogram (ECG). Monitor your pet at home for serious side effects.

How do I store sotalol?

Store this medication at room temperature 68°F to 72°F (20°C to 22°C).

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility.

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