Medication Description: Sotalol (Sotalol)
4ґ- [1-Oxy-2- (isopropylamino) ethyl] methanesulfonanilide.
Available in the form of hydrochloride.
Synonyms: Gilukor, Darob, Lortimik, Sotahexal, Sotaleks, Tahitalol, Berlex, Betapace, Darob, Gilucor, Loritmic, Sotahexal, Sotalex, Tachytalol.
White crystalline powder. Soluble in water, ethanol and propylene glycol.
It is a non-selective blocker of β 1 - and β 2 - adrenergic receptors, at the same time, by electrophysiological properties, it belongs to class III antiarrhythmic drugs.
Like other β-adrenergic blockers (attributed to class II antiarrhythmics) sotalol reduces the frequency and strength of heart contractions, slows down atrioventricular conductivity; At the same time, like amiodarone and other class III antiarrhythmics, it blocks the potassium current of delayed rectification, increases the duration of the action potential and the absolute refractory period in all parts of the cardiac conduction system. These features of sotalol gave reason to consider it an antiarrhythmic class III and II (mixed mechanism of action).
When ingestion is quickly and completely absorbed, bioavailability is about 100%, T Ѕ - 7-18 h; practically does not undergo biotransformation in the liver, excreted mainly by the kidneys.
Assign mainly with ventricular tachyarrhythmias, including ventricular fibrillation, ventricular tachycardia, tachycardia in patients with thyrotoxicosis; rarely with supraventricular tachyarrhythmias.
According to data published in foreign medical literature, the effectiveness of sotalol with long-term use significantly (2 times with 4-year observation) exceeded the total effectiveness of various class I antiarrhythmics in relation not only to preventing the recurrence of dangerous ventricular arrhythmias, but also to preventing the so-called "arrhythmic" and "Heart" death and death from all causes.
It can also be used for exertional angina pectoris (especially in combination with tachyarrhythmias) and for arterial hypertension.
Usually used internally in the form of tablets (before meals with a small amount of water) in a dose of 0.04 g 2-3 times a day. If necessary, a single dose is increased (with an interval of 2-3 days) to 0.08-0.16 g and, depending on the effect and tolerance, to 0.24-0.32 g 2 times a day. The treatment is carried out under careful medical (cardiac) observation.
When paroxysmal arrhythmias are injected intravenously at 0.02-0.12 g for 10 minutes under the control of ECG and blood pressure, if necessary, re-administered at intervals of 6 hours.
Possible side effects are the same as those of other non-selective β-blockers (see Anaprilin). Sometimes there is an arrhythmogenic effect (tachycardia like "pirouette").