Description of the medicine: Sotalol (Sotalol)
4ґ- [1-hydroxy-2- (isopropylamino) ethyl] methanesulfonanilide.
Available in the form of hydrochloride.
Synonyms: Gilukor, Darob, Loritmic, Sotagexal, Sotaleks, Tachitalol, 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, while at the same time it belongs to class III antiarrhythmic drugs by electrophysiological properties.
Like other β-adrenoblockers (classified as class II antiarrhythmics), sotalol reduces the frequency and strength of heart contractions, slows atrioventricular conduction; however, 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 the action of sotalol gave reason to consider it an antiarrhythmic of class III and II (a mixed mechanism of action).
When taken orally, it is rapidly and completely absorbed, bioavailability is about 100%, T Ѕ - 7-18 hours; 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 during prolonged use significantly (2 times with 4-year follow-up) exceeded the total effectiveness of various class I antiarrhythmics in relation not only to the prevention of recurrence of dangerous ventricular arrhythmias, but also the prevention of the so-called "arrhythmic" and "Cardiac" death and death from all causes.
It can also be used for angina pectoris (especially in combination with tachyarrhythmias) and for arterial hypertension.
Usually used orally in the form of tablets (before meals, washed down with a small amount of water) at 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. Treatment is carried out under careful medical (cardiological) supervision.
In case of paroxysmal arrhythmias, they are administered intravenously at 0.02-0.12 g for 10 minutes under the control of ECG and blood pressure, if necessary, they are repeated at intervals of 6 hours.
Possible side effects are the same as those of other indiscriminate β-blockers (see Anaprilin). Arrhythmogenic effect is sometimes observed (tachycardia of the “pirouette” type).