laguna n

iam 49 years and been using 150 mg rhythmol 3 times daily and moving to another country where rhythmol is not avaliable but sotalol is avaliable, now is it safe to switch to sotalol and are there any side effects and is rhythmol better than sotalol

[Michael J. McWilliams, M.D.]

Hello,
The mechanism of Rythmol and sotalol are completely different but have about equal efficacy.  Sotalol requires a 72 hour in patient admission to initiate the drug and monitor EKG intervals for changes -- this is very important.  If you are initiated on the sotalol and have someone that can follow it where you are moving, it is an ok choice.  

I tend to use rythmol first line in structurally normal hearts because it has a very good side effect profile. Sotalol tends to have more side effects of fatigue when compared to flecainide and propafenone (rythmol) because sotalol has more beta blocker properties. You might find that one works better for you than the other. Rythmol is a better converting agent, meaning that if you go into AF rythmol has a better chance of converting you to a normal rhythm.  Overall, sotalol is not a bad choice as long as it is initiated under a monitored setting and your kidney function is good.

I hope this answers your questions.  Good luck with your move and thanks for posting.