Both safety (heart rate, QT interval) and efficacy (arrhythmia control) should be closely monitored.Sotalol is available as the trade name Betapace and Betapace AF. We comply with the HONcode standard for trustworthy health information - sotalol: (atrial fibrillation, ventricular arrhythmia): -Initial dose: 80 mg orally 2 times a day -Doses should be adjusted gradually every 3 days in order to attain steady state plasma concentrations and allow for monitoring of QT intervals. In the U.S. multicenter dose-response study, the 120 mg dose (BID or QD) was found to be the most effective in prolonging the time to ECG documented symptomatic recurrence of AFIB/AFL. The trade name Betapace (R) is for ventricular arrhythmia only and the trade name Betapace AF (R) is for atrial fibrillation only. Use of sotalol in any age group with decreased renal function should be at lower doses or at increased intervals between doses. • Recommended initial dose is 80 mg PO q 12h if CrCl > 60mL/min • Dose may be increased in increments of 80 mg per day every 3 days, if QTc < 500 msec • Continually monitor patients until steady state blood levels are achieved • In most patients, therapeutic response is obtained at total daily dose of 160 to 320 mg/day, Select one or more newsletters to continue. If the 120 mg dose does not reduce the frequency of early relapse of AFIB/AFL and is tolerated without excessive QT interval prolongation (≥520 msec), an increase to 160 mg (BID or QD depending upon the creatinine clearance), can be considered. If QT is 520 msec or greater (JT 430 msec or greater if QRS is > 100 msec), the dose of Betapace AF therapy should be reduced and patients should be carefully monitored until QT returns to less than 520 msec. Alternatively, duringhospitalization, the dose can be increased to 120 mg BIDand the patient followed for 3 days on this dose (followed for 5 orIf the 80 mg dose level (given BID or QD depending upon the creatinine clearance) does not reduce the frequency of relapses of AFIB/AFL and is tolerated without excessive QT interval prolongation (i.e., ≥520 msec), the dose level may be increased to 120 mg (BID or QD depending upon the creatinine clearance). Most patients respond to a daily dose of 160 to 320 mg administered in two divided doses at approximately 12 hour intervals. Betapace/Betapace AF, sotalol oral solution, and sotalol injection are contraindicated in patients with renal failure or renal impairment (creatinine clearance (CrCl) less than 40 mL/minute); for Betapace/Betapace AF, this contraindication only applies if used for the treatment of atrial fibrillation or atrial flutter. These two trade names are not interchangeable.Dose adjustments should be done gradually allowing 2 to 3 days between dosing increments.Extreme caution should be exercised in patients with renal failure undergoing hemodialysis.
Beta Blocker Heart Meds Might Pose Special Risks for Women We comply with the HONcode standard for trustworthy health information - When serum creatinine is given in μmol/L, divide the value by 88.4 (1 mg/dL = 88.4 μmol/L).The steps described above are summarized in the following diagram:If Clcr is <40 mL/min Betapace AF is CONTRAINDICATEDIf QT <500 msec after 3 days (after 5th or 6th dose ifdischarge patient on current treatment. Step 4.
Monitoring of heart rate and QTPatients with a history of symptomatic AFIB/AFL who are currently receiving Betapace for the maintenance of normal sinus should be transferred to Betapace AF because of the significant differences in labeling (i.e., patient package insert, dosing administration, and safety information).Before starting Betapace AF, previous antiarrhythmic therapy should generally be withdrawn under careful monitoring for a minimum of 2-3 plasma half-lives if the patient's clinical condition permits (see Betapace AF Syrup 5 mg/mL can be compounded using Simple Syrup containing 0.1% sodium benzoate (Syrup, NF) available from Humco Laboratories as follows:The endpoint is achieved when a dispersion of fine particles in the syrup is obtained.This compounding procedure results in a solution containing 5 mg/mL of sotalol HCl.
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