Initial Sotalol Dosing

[rinty51]

Im recently diagnosed with A-Fib and am sheduled for an electro-cardioversion next week (after 4 weeks warfarin therapy).  The cardiologist wants to start me on Sotalol 3 days before on an outpatient basis.  I've read where Sotalol should only be started in a closely monitored hospital setting for 3 days. (WebMD, NIH.gov, others..), and tells me this is common practice.  

I would appreciate hraing from others on Sotalol as to how their dosage was started..

Thanks,
Rick

[suzah48]

Sorry I am new to this forum and posted the above comment somehow to BobRBob instead of you.  I just wanted to add that as part of the monitoring they did an EKG 2 hours after each of the doses to check on my heart rhythm and QTC intervals to see if the same dose should be give again.

[suzah48]

I was just started on Sotalol in the hospital, 120 mg 2x daily.  I was scheduled for a cardioversion after 3 days on the Sotalol but the drug converted me 4 hours after the first dose.  I have been monitored 24/7 and I am still in NSR but after the 6th dose my heart rate dropped into the 40's and I was getting dizzy. The dose was cut back to 80 mg 2x day today.  Waiting to see what happens to my heart rate now. That is probably why it is started in the hospital and monitored, so adjustments can be made if necessary.

[twinbee]

My EP started me on Sotalol in the hospital.

[rinty51]

Still not sure what I'm going to do, but thanks for your help

[BobRBob]

I think you should stay with your doctor. Nothing you've said raises any particular concern with the treatment you are receiving. The effective anti-arrhythmic drugs all have risks, some worse than others. You are starting the drug therapy before the electro-cardioversion so there may be a chance you will convert from the drug and avoid the shock treatment.

[rinty51]

I guess that my cardiologist has the same reasons yours did.   His nurse told me he never has started someone in a hospital setting.   If so, why all these warnings.  

This is my first go-round with A-Fib, cardioversion, warfarin et al.   Reading about potentially lethal side-effects has rattled me a bit, and has me thinking of changing doctors.

[BobRBob]

I take Sotalol for a-fib and it has been holding me in NSR effectively since early July. Side effects are a bit of a bother but I am coping; you may not have that problem. As planned for you, I was simply sent home with the prescription and started taking the drug with no monitoring. Also like you, I discovered from reading that the usual procedure in the US (I live in Canada) is to load this drug in a hospital setting with full monitoring 24/7 for 3 days. I asked my cardiologist about this when I next saw him and he said that the risk factors are well understood and I exhibit none of them so the monitoring was not required. He was right I guess; I'm still here.

This is a strong and effective drug. During the first couple of weeks I noticed random bumps and zings in my chest as well as occasional pounding. It also really slowed my heart rate.