Sotalol is a beta-blocker that affects the heart and circulation within the atrium and ventricles (the upper and lower chambers of the heart that allow blood to flow into and out of the heart).

Sotalol is used to help keep the heart beating normally in people with certain heart rhythm disorders, such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation.

Sotalol may also be used for purposes not listed in this medication guide.

You should not use sotalol if you have asthma, low potassium, or a serious heart condition such as severe heart failure, long QT syndrome, slow heartbeats that have caused you to faint, "sick sinus syndrome" or "AV block" (unless you have a pacemaker).

You will receive your first few doses of sotalol in a hospital setting where your heart can be monitored in case the medicine causes serious side effects.

Sotalol comes as a tablet to take by mouth. Sotalol (Betapace) is usually taken twice a day and sotalol (Betapace AF) is usually taken once or twice a day. Take sotalol consistently, either with food or without food each time. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take sotalol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Sotalol controls your condition but does not cure it. Continue to take sotalol even if you feel well. Do not stop taking sotalol without talking to your doctor. If sotalol is stopped suddenly, it may cause chest pain or heart attack.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Sotalol oral is taken by mouth. Sotalol injection is given as an infusion into a vein. A healthcare provider will give you this injection if you are unable to take the medicine by mouth.

You will receive your first few doses of sotalol in a hospital setting where your heart can be monitored in case the medicine causes serious side effects.

If you already take heart rhythm medication, you may need to stop taking it when you start using sotalol. Carefully follow your doctor's instructions.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Sotalol doses are based on age and body surface area (height and weight) in children. Your child's dose needs may change if the child gains or loses weight, or is still growing.

Call your doctor if you are sick with vomiting or diarrhea, or if you have increased thirst, decreased appetite, or are sweating more than usual. You can easily become dehydrated while taking sotalol. This can lead to very low blood pressure, a serious electrolyte imbalance, or kidney failure.

You will need frequent medical tests. Your heart function may need to be checked using an electrocardiograph or ECG (sometimes called an EKG). You may also need heart function tests for 1 to 2 weeks after your last dose.

Keep using this medicine as directed, even if you feel well. You may need to take sotalol for the rest of your life.

Do not skip doses or stop using sotalol without your doctor's advice. Stopping suddenly may make your condition worse. Follow your doctor's instructions about tapering your dose.

If you need surgery, tell your surgeon you currently use this medicine.

Store at room temperature away from moisture and heat. Do not allow liquid medicine to freeze.

Your pharmacist may prepare an oral suspension (liquid) form of sotalol. Keep the suspension at room temperature and throw away suspension any left over after 3 months of use.

You should not use sotalol if you are allergic to it, or if you have:

• a serious heart condition such as "sick sinus syndrome" or "AV block" (unless you have a pacemaker);

• long QT syndrome (in you or a family member);

• severe heart failure;

• slow heartbeats that have caused you to faint;

• asthma or other breathing disorder;

• very low levels of potassium in your blood; or

• (if you take sotalol for atrial fibrillation or atrial flutter) severe kidney disease;

Do not give sotalol to a child without medical advice.

Tell your doctor if you have ever had:

• kidney disease (or if you are on dialysis);

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

• congestive heart failure;

• coronary artery disease (hardened arteries);

• breathing problems such as bronchitis or emphysema;

• a thyroid disorder;

• diabetes (using sotalol can make it harder for you to tell when you have low blood sugar);

• a severe allergic reaction.

Tell your doctor if you are pregnant.

You should not breastfeed while using sotalol.

Skip the missed dose and use your next dose at the regular time. Do not use two doses at one time.

Try not to miss any doses. Get your prescription refilled before you run out of medicine completely.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of sotalol can be fatal.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

Talk to your doctor before using salt substitutes containing potassium. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

Avoid taking an antacid within 2 hours before or 2 hours after you take sotalol. Some antacids can make it harder for your body to absorb sotalol.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Sotalol may cause serious side effects. Call your doctor at once if you have:

• chest pain;

• fast or pounding heartbeats, fluttering in your chest;

• sudden dizziness (like you might pass out);

• slow heartbeats (especially if you feel light-headed);

• swelling, rapid weight gain; or

• feeling short of breath.

Common side effects of sotalol may include:

• slow heartbeats;

• trouble breathing;

• dizziness; or

• feeling weak or tired.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• other heart medications;

• blood pressure medication; or

• insulin or oral diabetes medicine.

This list is not complete. Other drugs may affect sotalol, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Keep all appointments with your doctor and the laboratory. Your blood pressure should be checked regularly to determine your response to sotalol. Your doctor may ask you to check your pulse (heart rate). Ask your pharmacist or doctor to teach you how to take your pulse. If your pulse is faster or slower than it should be, call your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.