Betapace

Posted by terry on May 28, 1999 at 09:12:18
I've been taking Betapace for almost 5 yrs now....have tried other beta blockers with none being as effective as the Betapace.  Occasionally, there seems to be "break through" arrhythmias...for a number of days. this is occuring now.  Heart rate is typically in the high 40's when waking up in the morning. I'm aware of the possible "lethal" side effects related to betapace. Having taken it for so long, is it less likely that these side effect will occur?  Could the arrythmias be occurring as a result of  a systemic tolerance to the medication, thus reducing it's efficacy? Should I be looking for a different medication with my cardiologist?  Would appreciate your input.  TIA

Posted by CCF CARDIO MD - CRC on May 28, 1999 at 11:10:31
Dear Terry,
The lethal side-effects are only present when one is first starting the medication and this is why it is usually started in the hospital under close observation.  One dosen't usually develop tolerance to beta-blockers.  What type of arrhythmia are you taking the betapace for and what type of palpitations are you now having?
Here is some general information about betapace.
Sotalol (brand name Betapace) is a Class II and III antiarrhythmic that comes in 80, 120, 160 and 240 mg tablets.  It is indicated for a variety of heart arrhythmias.  It is usually initiated in the hospital on ECG monitoring due to a potential for inducing ventricular tachycardia.  The dosage starts at 80 mg twice daily and may be increased as needed.
Contraindications: Asthma, sinus bradycardia, 2nd or 3rd degree AV block unless paced, long QT syndromes, cardiogenic shock, uncompensated heart failure.
Precautions: sick sinus syndrome, heart failure, recent MI, diabetes.  Not recommended in nursing mothers.
Drug interactions: Avoid Class 1A and Class III antiarrhythmics; caution with Class I antiarrhythmics; phenothiazines, tricyclic antidepressants, astemizole.
Potential adverse reactions: bradycardia, chest pain, palpitations, edema (swelling) ECG abnormalities, hypo- or hypertension, dyspnea (shortness of breath), asthma, dizziness, fatigue, headache, fainting, GI upset and rash.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.