Medication: Sotalol

Your cat has been prescribed sotalol for management of abnormal heart rhythms.  

Key points: 
• Non-selective beta blocker. 
• Used to slow the heart rate and treat irregular heart rhythms.  
• Can cause low blood pressure. 
• Do not use in animals with certain conditions causing slow heart rate. 
• Use with care in animals with chronic heart disease or heart failure. 
• Use with care in animals with kidney disease. 
• Use with care in animals with asthma.  
• Use with care in pregnant or lactating animals as enters the milk. 
• Dosage: usually twice daily dosing.   
• Do not stop treatment suddenly always taper dose and withdraw. 

This information sheet is designed to help answer commonly asked questions and help you give the medication safely and effectively to your pet. It does not contain all available information for this medication. If you have other questions or need more information, contact your veterinarian or pharmacist.Always follow the dosing instructions provided by your veterinarian.  

Name 

• Sotalol (SO- TA- LOL). 

Brand name 

• There is no product licensed for use in pets but human drugs can be given with special consent. 
• Sotacor® (Europe & UK). 
• Betacardone® (Europe & UK). 
• Betapace® (US). 
• Sorine® (US). 
• Sotylize® (US). 

Class of medication 

• Beta blocker. 

Storage 

• Store at room temperature (15-30°C/59-86°F).  
• Store away from heat, moisture and sunlight.  

Your veterinarian has prescribed sotalol for the treatment of a cardiac arrhythmia (abnormal heart rate/irregular beats). 

The product is available as tablets or solution which can be given by mouth. The tablets should be administered directly into your cat’s mouth and not mixed with food as this reduces absorption. 

The following side-effects have been reported and are more common in older animals: 

• Abnormally slow heart rate. 
• Abnormal heart rhythm or worsening of pre-existing abnormal heart rhythm (this is called a proarrhythmic effect). 
• Heart failure.  
• Nausea, vomiting and diarrhea. 
• Loss of appetite. 
• Fainting. 
• Depression and lethargy. 
• Exacerbation of asthma (bronchospasm). 

Drug interactions  

• Some drugs that stimulate the sympathetic nervous system, eg epinephrine; phenylpropanolamine and terbutaline – sotalol can block their effect. 
• Calcium channel blockers, eg diltiazem, verapamil – may increase risk of slow heart rate, low blood pressure and heart failure. 
• Can enhance the effect of other beta blockers, eg atenolol.  
• Can react with anesthetic agents to reduce heart function. 
• Insulin – sotalol may extend the effects of insulin thereby lowering blood glucose.

Sotalol should be administered according to your veterinarian’s instructions. Treatment may be started at a low dose and then may be gradually increased over time. If treatment is effective the drug may be continued lifelong. If no improvement is seen within a few months, your veterinarian may recommend a different course of therapy. You should never change or stop any treatment without consulting your veterinarian.  

Dispose of any unused sotalol safely – do not flush down the toilet or sink. Ask your veterinary team if they take back medication for disposal. Do not save for future use or give to other pets. 

If you miss a dose, give the dose as soon as possible but do not give a double dose. Make sure the dose given does not exceed the total recommended dose in any 24-hour period. 

If your pet is unwell, contact your veterinarian for advice. 

Sotalol should only be given to the cat that it has been prescribed for: 

• Do not give to other pets in the household. 
• Use with care in pregnant or lactating pets and only if advised by your veterinarian. 
• If accidentally given to other pets, contact your veterinarian for advice. 

If accidentally consumed by a human, speak to your primary care physician or poison control center.

Your veterinarian will want to make regular checks on your cat if they are receiving any long term therapy to ensure the drugs they are receiving are effective and to adjust the doses if necessary. Regular ECG monitoring will be performed if sotalol is prescribed to manage a heart rhythm abnormality. 

Further information 

If you have any concerns, further information on sotalol can be found on the package insert and the following websites: 

Europe & UK

• There are no licensed products for cats or dogs. 
• Sotacor® (80 mg tablets): www.medicines.org.uk/emc/files/pil.9407.pdf 
• Betacardone® tablets (40 mg, 80 mg, 12 mg). Website: imedi.co.uk/betacardone-tablets-40mg 

USA

• There are no licensed product for cats or dogs. 
• Betapace® tablets (80 mg, 120 mg, 160 mg, 240 mg): www.accessdata.fda.gov/drugsatfda_docs/label/2011/021151s010lbl.pdf 
• Sorine® tablets (80 mg, 120 mg, 160 mg, 240 mg). Website: www.upsher-smith.com/products/sorine-sotalol-hcl-tablets-usp/ 
• Sotylize® solution (5 mg/ml). Website: sotylize.com/ 

Always follow the recommended dosage and contact your veterinary team or pharmacist if you have any questions regarding your cat’s medication.