Side Effects of sotalol: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major Research Findings

Sotalol is a beta-blocker with class III antiarrhythmic properties, often used for long-term treatment in human patients and small animals. 15 Although proven effective in treating tachyarrhythmias, sotalol is proarrhythmic and can cause torsades de pointes. 17 Sotalol is prone to drug interactions and requires caution when used in conjunction with other drugs. 5 Sotalol can prolong the QT interval, potentially leading to torsades de pointes (TdP), a life-threatening arrhythmia. 25 Sotalol can cause severe liver toxicity. 4 Sotalol can cause myasthenia gravis. 9 Sotalol can cause hyperkalemia. 21 Sotalol can affect fetal heart rate. 2 Sotalol may have adverse effects on the fetus if used during pregnancy. 2 Sotalol can increase the risk of side effects when used in combination with antipsychotics. 7

Reasons for Side Effects

Sotalol is a beta-blocker used to regulate electrical activity in the heart and treat arrhythmias such as atrial fibrillation and ventricular tachycardia. However, because sotalol also has a heart muscle-weakening effect, it may increase the risk of side effects in patients with heart conditions such as hypertrophic cardiomyopathy. 1 Sotalol can prolong the QT interval, potentially leading to torsades de pointes (TdP), a life-threatening arrhythmia. 25 These side effects are thought to be caused by sotalol's ability to regulate electrical activity in the heart and its heart muscle-weakening effect.

Common Side Effects

QT Interval Prolongation

Sotalol can prolong the QT interval. 25 The QT interval is the time from the start of the ventricular depolarization to the end of the ventricular repolarization. Prolongation of the QT interval can lead to torsades de pointes (TdP), a life-threatening arrhythmia. 25

Torsades de Pointes (TdP)

Sotalol can cause torsades de pointes (TdP). 25 TdP is a type of irregular heartbeat that can be life-threatening.

Hyperkalemia

Sotalol can cause hyperkalemia. 21 Hyperkalemia is a condition where there is an abnormally high concentration of potassium in the blood. Hyperkalemia can have adverse effects on the heart.

Liver Toxicity

Sotalol can cause severe liver toxicity. 4 Liver toxicity is a condition where the liver's function is impaired. Liver toxicity can be life-threatening.

Myasthenia Gravis

Sotalol can cause myasthenia gravis. 9 Myasthenia gravis is a disease that causes muscle weakness. Myasthenia gravis can interfere with daily life.

Countermeasures for Side Effects

QT Interval Prolongation

Before administering sotalol, doctors need to check the patient's electrical activity in the heart. 25 Regular checks of the electrical activity in the heart are necessary while the patient is taking sotalol. 25 If the QT interval is prolonged, doctors may need to adjust the dosage of sotalol or discontinue its use. 25

Torsades de Pointes (TdP)

If TdP occurs, consult a doctor immediately. 25 TdP can be life-threatening, so prompt treatment is essential.

Hyperkalemia

If symptoms of hyperkalemia appear, consult a doctor immediately. 21 Hyperkalemia can have adverse effects on the heart, so prompt treatment is essential.

Liver Toxicity

If symptoms of liver toxicity appear, consult a doctor immediately. 4 Liver toxicity can be life-threatening, so prompt treatment is essential.

Myasthenia Gravis

If symptoms of myasthenia gravis appear, consult a doctor immediately. 9 Myasthenia gravis can interfere with daily life, so prompt treatment is essential.

Comparison Between Studies

Commonalities Between Studies

These studies demonstrate the potential for sotalol to cause a range of side effects. These side effects are thought to be caused by sotalol's ability to regulate electrical activity in the heart and its heart muscle-weakening effect.

Differences Between Studies

These studies suggest that the types and severity of sotalol side effects may vary between patients. 17 For example, one study showed that sotalol is likely to prolong the QT interval, while another study showed that sotalol is likely to cause myasthenia gravis.

Points to Note Regarding Real-Life Application

Sotalol is an effective medication for treating heart disease, but it can cause a variety of side effects. 17 It's crucial to discuss with your doctor and understand the risks of side effects before taking sotalol. 10 Regular doctor visits are also essential while taking sotalol. 10 Sotalol can increase the risk of side effects when used in combination with other medications, so always consult your doctor if you are taking other medications. 5

Limitations of Current Research

There is still a lack of sufficient research on sotalol side effects. Further research is needed. In particular, more detailed studies are needed on the effects of sotalol on patients with various heart conditions.

Future Directions for Necessary Research

Further research on sotalol side effects should focus on the following areas:

  • Studies investigating the impact of sotalol on patients with various heart conditions
  • Studies investigating ways to mitigate sotalol side effects
  • Studies investigating methods for predicting sotalol side effects

Conclusion

Sotalol is an effective medication for treating heart disease, but it can cause a variety of side effects. 17 It's crucial to discuss with your doctor and understand the risks of side effects before taking sotalol. 10 Regular doctor visits are also essential while taking sotalol. 10 Sotalol can increase the risk of side effects when used in combination with other medications, so always consult your doctor if you are taking other medications. 5

Literature analysis of 25 papers
Positive Content
17
Neutral Content
2
Negative Content
6
Article Type
2
1
2
6
25
5.

Prevalence of potential drug-drug interactions in outpatients of a general hospital in China: a retrospective investigation.

Author: RenWeifang, LiuYujuan, ZhangJun, FangZhonghong, FangHuan, GongYuan, LvXiaoqun

drug safety improvement
adverse drug reactions
drug interactions

Potential drug-drug interactions are prevalent in real-world practice. Computerized surveillance and warning systems are needed to reduce the risk of adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Biomarkers of pre-existing risk of Torsade de Pointes under Sotalol treatment.

Author: CrucesPablo Daniel, TorkarDrago, AriniPedro David

Arrhythmia treatment

A study of patients with and without a history of Torsade de Pointes (TdP) undergoing a Sotalol challenge found that quaternion algebra-based spatial biomarkers could accurately distinguish patients with arrhythmogenic substrate. These biomarkers measured drug-induced changes and pre-existing risk factors, outperforming current standards.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Adverse effects of interactions between antipsychotics and medications used in the treatment of cardiovascular disorders.

Author: SiwekMarcin, WorońJarosław, GorostowiczAleksandra, WordliczekJerzy

CVD treatment

This study aimed to evaluate the potential for harmful interactions between antipsychotics and medications used to treat cardiovascular diseases (CVD) in patients with bipolar disorder or schizophrenia who are at risk of CVD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Antiarrhythmic Drugs or Catheter Ablation in the Management of Ventricular Tachyarrhythmias in Patients With Implantable Cardioverter-Defibrillators: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Author: KheiriBabikir, BarbarawiMahmoud, ZayedYazan, HicksMichael, OsmanMohammed, RashdanLaith, KyiHtay Htay, BachuwaGhassan, HassanMustafa, SteckerEric C, NazerBabak, BhattDeepak L

Reduced ICD shocks
Reduced VT

This study evaluated the efficacy and safety of antiarrhythmic drugs and catheter ablation (CA) in treating ventricular tachyarrhythmias (VT) in patients with an implantable cardioverter-defibrillator (ICD).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

Sotalol-induced generalized and ocular myasthenia gravis.

Author: SharifkazemiMohammadbagher, ZiyaFarzad

Myasthenia gravis

This case report describes a patient with end-stage hypertrophic cardiomyopathy who developed myasthenia gravis as a rare neurological complication of sotalol.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

11.

Anti-arrhythmic drug therapy in implantable cardioverter-defibrillator recipients.

Author: AlTurkiAhmed, ProiettiRiccardo, RussoVincenzo, DhanjalTarvinder, BanerjeePrithwish, EssebagVidal

Arrhythmia prevention
Reduced risk
Side effects

This abstract discusses the use of anti-arrhythmic drugs (AADs) in patients with ventricular arrhythmias who have implantable cardioverter-defibrillators (ICDs). It highlights the role of beta blockers and amiodarone as primary and secondary prevention strategies, as well as the emerging use of dofetilide, azimilide, and ranolazine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Drug-induced QT Interval Prolongation in the Intensive Care Unit.

Author: EtchegoyenCecilia Villa, KellerGuillermo Alberto, MradSebastian, ChengSixuan, Di GirolamoGuillermo

Drug-induced LQTS

This study addresses drug-induced QT interval prolongation, the most common acquired cause of Long QT syndrome (LQTS), which is characterized by an extended duration of the ventricular repolarization. This syndrome increases the risk for polymorphic ventricular tachycardia and sudden death.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Does Sotalol Still Have a Role in the Management of Arrhythmias?

Author: Semasinghe BandaralageSahan P, NirthananSelvanayagam, NiranjanSelvanayagam

Effective for tachyarrhythmias
Proarrhythmic effects
Torsades de pointes

Sotalol is a medication used to treat tachyarrhythmias. This study discusses the potential benefits and risks of sotalol, considering recent developments in the management of atrial fibrillation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Drug-induced torsades de pointes in an underserved urban population. Methadone: is there therapeutic equipoise?

Author: RomeroJorge, BaldingerSamuel H, Goodman-MezaDavid, EngstromKrysthel, ValenciaCarolina R, GoliveAnjani, MedranoFrancisco, RangasamySabarivinoth, MakkiyaMohammed, FisherJohn D, GrossJay, KrumermanAndrew, KimSoo, GarciaMario J, Di BiaseLuigi, FerrickKevin J

Prolonged QTc
Torsades de pointes

A retrospective review of 2735 patients with prolonged QTc found that methadone was by far the leading medication implicated in the development of torsades de pointes (TdP), even though it was not the most common QT-prolonging medication in the population. Methadone was an independent predictor of TdP in both univariate and multivariate analyses. Other medications associated with TdP included furosemide, SSRIs, amiodarone, and dofetilide.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Life-threatening hyperkalemia: a potentially lethal drug combination.

Author: JuvetTristan, GourineniVenkata C, RaviSandeep, ZarichStuart W

Hyperkalemia

Hyperkalemia is a common and potentially fatal condition in the elderly. This case report describes an 85-year-old woman who developed profound hyperkalemia after inadvertently combining several potassium-sparing medications. The patient subsequently recovered after treatment with pharmacologic agents and emergency hemodialysis.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

22.

Update on treatment of essential tremor.

Author: ZesiewiczTheresa A, ShawJessica D, AllisonKevin G, StaffettiJoseph S, OkunMichael S, SullivanKelly L

Essential tremor treatment
Medication side effects

Propranolol is the only FDA-approved medication for essential tremor (ET), but other medications, such as primidone, topiramate, and atenolol, may also be effective. Deep brain stimulation (DBS) is an alternative treatment for patients who don't respond well to medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

23.

Treatment of essential tremor: a systematic review of evidence and recommendations from the Italian Movement Disorders Association.

Author: ZappiaMario, AlbaneseAlberto, BrunoElisa, ColosimoCarlo, FilippiniGraziella, MartinelliPaolo, NicolettiAlessandra, QuattrocchiGraziella, AbbruzzeseGiovanni, BerardelliAlfredo, AllegraRoberta, AnielloMaria Stella, EliaAntonio E, MartinoDavide, MurgiaDaniela, PicilloMarina, SquintaniGiovanna

First-line therapy
Refractory ET treatment
Second-line treatment
Side effects

This review assesses the current state of knowledge regarding essential tremor (ET) therapy. Propranolol, primidone, and topiramate are recommended as first-line treatment options, while botulinum toxin type A and thalamic deep-brain stimulation are reserved for refractory ET.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

25.

Covariate analysis of QTc and T-wave morphology: new possibilities in the evaluation of drugs that affect cardiac repolarization.

Author: GraffC, StruijkJ J, MatzJ, KantersJ K, AndersenM P, NielsenJ, ToftE

Improved repolarization assessment

This study evaluated the effects of moxifloxacin and D,L-sotalol on cardiac repolarization, using a T-wave morphology composite score (MCS) in addition to the QTc interval. The researchers found that D,L-sotalol had a significant effect on T-wave morphology, while moxifloxacin did not.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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