Sotalol Question

[Suzie2127]

If anyone else is on Sotalol, I have a problem I need help with. I have been on Sotalol for a year and a half. My local cardiologist recently upped my dose because I've had to be cardioverted three times in six months. When my husband picked it up, the new prescription said Sotalol AF. In the past it has always been Sotalol HCL. I called the local pharmacy who told me they were the same thing. Didn't seem right, so I went to the company website where it says:

"All new and existing patients currently taking BetapaceR (sotalol HCl) or generic sotalol for atrial fibrillation should be transferred to BetapaceAF™. Betapace and generic sotalol are not approved for the AFIB/AFL indication and should not be substituted for BetapacAF™. BetapaceAF™ is the only sotalol approved for highly symptomatic AFIB."

Called the company who said they are not the same and are not interchangeable. Went to my electorphysiologist today who said they are the same--that the company just wants you to buy the expensive Sotalol instead of the generic. Does the same company make the regular and the generic?
Anybody know?

[Suzie2127]

Yes. . .they pushed my HR too low. One time in the Dr.'s office they couldn't get my pulse or blood pressure because of the meds. The pacemaker has allowed me to be able to take beta blockers. Thanks again.

[Jerry_NJ]

You have a very complicated set of heat issues so I (happily) can't directly relate to the set.  But, I do believe an anticoagulant and Plavix work very differently. My simple understanding is an anticoagulant reduces the "bloods ability" to coagulate, whereas Plavix makes the blood cells more "slippery".  Most importantly you have checked out the medications with you doctor, he/she is the one who must decide what is best for you.  

As a parallel example, I take both a beta blocker and a calcium channel blocker to lower my HR, they both lower HR and BP, but they have different mechanisms.  I believe the BB blocks some of the electrical signals, and the CCB relaxes/enlarges the arteries.  It is still possible that acting together the HR and/or BP could be pushed too low, but that hasn't happened in my case.  

[Suzie2127]

Thanks for you reply. I thought I had finally resolved this issue that HCL was the generic and AF the patented medicine. And then I heard from someone else that their pharmacy told them they were not interchangeable so I'm back to square one. And, yes, I am now on Pradaxa. But that also brings questions because I am also on Plavix for stents and it bothers me to be on both, but the the doctors say I should be. I have AFib, an implanted defibrillator/pacemaker and two stents after a major heart attack and SCD.

[Jerry_NJ]

Sounds "fishy" to me.  

Good that you checked it out, but strange that your ER would have a different answer than the manufacturer of the drug.

There can be some differences between patented medications and generics.  I have never had a problem with a generic substitute.

I have discussed Satalol with my Cardiologist in years past, but I have never taken it.  I do understand it is one of the more powerful (with associated risks) medications and does demand the careful handling you are giving it.

If you can hold of taking it until you get it cleared up with your doctor, that would be best in my mind.  

I assume you are on an anticoagulant, clots being one of the main risks of AFib.