Sotalol is a beta blocker and a potassium channel blocker; it thus is an antiarrhythmic falling into two classes of the Vaughan Williams classification.
Like other beta blockers, sotalol decreases the heart rate via slowing of conduction in the atrioventricular node.
Unlike other beta blockers sotalol lengthens the duration of monophasic action potentials in the atria and the ventricles. The drug prolongs refractoriness not only in atrial and ventricular myocardium but also in the atrioventricular node, the His - Purkinje system, and atrioventricular bypass tracts. Also it has less of a negative ionotropic effect than other beta blockers (1).
Diuretics and hypokalaemia should be avoided when using sotalol (1).
The summary of product characteristics should be consulted before prescribing this drug.
- Committee on Safety of Medicines (1996). Restricted indications for sotalol (Sotacar, Beta-Cardone). Current Problems in Pharmacovigilance, 22, 6-7.