Transition from Sotalol to Dronederone

[BobRBob]

I have been on Sotalol for over a year to control my a-fib. Recently, I've started to have breakthroughs and my cardiologist has prescribed Dronederone (Multaq) in place of the Sotalol. He has also referred me to an EP to investigate an ablation. My question relates to the transition from Solalol to Dronederone. My cardiologist told me to just switch from one drug to the other with no taper and no overlap. I'm wondering if anyone here has done this transition. The Sotalol is a beta blocker and it comes with a warning to not suddenly stop taking it. Of course, this warning assumes no alternate drug therapy in it's place but I'm still concerned that I may develop tachycardia or some other condition upon withdrawal of the Sotalol even though I've switched to the Dronederone. My pharmacist agrees that this is the correct approach but I'm a little afraid at this point to just do it. Has anyone here had this experience? Dronederone is not a beta blocker.

[LindaTX]

Is Sotalol related to or in the same family as Multaq?   Like Rhythmol and Flecainide are in the same family.  Curious because I just came out of an ablation and went off Sotalol cold turkey because it was making me feel worse on it than I felt off it.

[BobRBob]

No, Sotalol is a beta blocker and anti-arrhythmic drug. Multaq is a very different chemical and is not a beta-blocker. Multaq (Dronederone) is actually similar in molecular structure to Amioderone but without the Iodine which makes the Ami so toxic.

Update on my crossover to Multaq...

It is now Sunday morning and I am still in normal rhythm (yay!). So far, the only side effect from the Multaq seems to be some heart racing and pounding for an hour or so after dosing. I've also noticed some anxiety and very slight teeth chattering in the morning the past 3 days as well, most likely an effect of the withdrawal from the Sotalol. Both were a bit better this morning so I'm hoping this will stop happening as I adjust to the Multaq and my body completely re-adjusts to the sudden removal of the beta blockade. I don't know how long this takes. Linda, how long were you on Sotalol before stopping? I was on it for over a year so my body was very used to it. With a half life of about 12 hours, the Sotalol is now virtually gone from my system.

[BobRBob]

Monday afternoon and still in normal rhythm. Still no noticeable side effects from the Multaq. Hard to believe given how awful the Sotalol was. Teeth chattering and nervousness has subsided so I guess I'm safely off the Sotalol...

[LindaTX]

Glad you are still in NSR....that means a lot! :)  I was only on Sotalol for a few days after I got out of the hospital.  It was keeping me at 103-108 bpm.  I finally converted into NSR and went to 72bpm immediately so I was worried about continuing the Sotalol because I hated to see my resting heart rate up so high.

I'm willing to do what I need to do but I don't feel like I'm getting any real clear direction from my EP's office.  After talking with them today they said they did get my EKG that was faxed to them LAST Wed.  They are supposed to call me back after talking to the Dr. about whatever med they want me on.  My normal resting rate is in the 60's so I reall miss that.

[BobRBob]

Great that you've converted Linda. Glad to hear it. Hopefully, this means your ablation is successful and you're healing. I have an appointment in December with an EP to investigate an ablation. I'm scared but it may be the only way.

I went into a-fib yesterday around 5pm but converted back at 10:30pm. One thing I noticed is the a-fib is smoother and less bothersome on this drug than it was on the Sotalol. I'm still hopeful though that this drug will stabilize and hold me in normal rhythm for extended periods. I've started to notice slightly cold hands today. Nothing too bad but noticeable.

[LindaTX]

Just got a call from my EP's office.  Instead of Sotalol, they want me go on Rhythmol 3 times a day....which is what I took a yr ago.  So hopefully it will keep my rhythm regular until I can discontinue it in a couple of months.  Yeah, don't rule out an ablation....a-fib is a progressive condition.  I didn't want an ablation but with my history i thought the time was right .  Only time will tell...there are no real guarantees.