Betapace (Sotalol) is a beta blocker. It treats an irregular heartbeat.
Betapace mechanism of action
Betapace is a beta-blocking agent with non-selective antiarrhythmic property (class II and class III). Its mechanism of action is due to the fact uniformly extend the length of the action potential in all cardiac tissues, which slows the repolarization phase without affecting the depolarization of the fiber.
Owing to its beta-adrenergic blocker decreases the heart rate (negative chronotropism) and a slight decrease in strength of ventricular contraction (negative inotropism), which leads to a reduction in myocardial oxygen consumption and cardiac work. Like other beta-blockers, inhibits release of renin both at rest and during exercise up to 24 hours after administration of a dose of sotalol única.Uma feature is that it is devoid of intrinsic sympathomimetic activity and membrane stabilizing action.
Betapace af prescribing information
Hemodynamic studies in cardiac arrhythmias showed that sotalol, at a dose of 160mg, reduces the frequency (21% -24%) and systolic or diastolic blood pressure (8%), but increases the ejection fraction (6% -10%) and stroke volume (10% -20%). After administration orally agent that non-selective beta-blocker is absorbed and its bioavailability is significantly higher than 90%, peak serum levels are achieved between 2.5 and 4 hours and plasma stabilization between 2 and 4 days.
Betapace and blood pressure
Bioavailability has a bicompartmental half-life from 7 to 15 horas.Não binds to plasma proteins or undergo metabolic degradation in the body. Little diffuses through the barrier (only reaches concentrations of 10% serum) and preferably eliminated by the kidneys in unchanged form.
Cardiac arrhythmias. Severe ventricular tachycardia, tachyarrhythmias, paroxysmal tachycardia. Arrhythmias caused by excess circulating catecholamines. Angina pectoris. Post-myocardial infarction.
Betapace dosage information
How antiarrhythmic: 80mg every 12 hours. In subjects with reduced myocardial function are employed 40mg, 2 times a day. The antiarrhythmic dose maximum is 640mg per day. The recommended dose for most patients is between 160 and 640mg daily.
Betapace and low blood pressure
As antianginal: 160mg per day and after one week of treatment may be increased to twice weekly (320mg/dia). The initial dose should be determined for each individual patient by controlling hemodynamic and cardiac.
Hemodialysis significantly reduces serum levels of sotalol. Symptoms of overdose are bradycardia, bronchospasm, collapse, hypotension, heart failure, hypoglycemia. Advise the following therapeutic resources. Severe bradycardia: atropine IV apply. AV block (second or third degree) transvenous pacemaker. Hypotension: epinephrine or isoproterenol. Bronchospasm: aminophylline, b 2 agonists aerosol. Torsade de pointes: magnesium sulfate, transvenous pacemaker.
Betapace Side effects
Sotalol is a well tolerated drug. Have been reported some occasional secondary reactions such as dyspnea, dizziness, headache, asthenia, bradycardia, hypotension, fever, which disappear with dose reduction or interruption of treatment. In 1% of patients described themselves an excessive prolongation of the QT interval.
You are advised to take special care in patients undergoing general anesthesia with possible potentiation by cyclopropane cardiodepressant. In diabetic subjects, sotalol may mask certain clinical signs (tachycardia) of acute hypoglycemia or hyperthyroidism.
Betapace for atrial fibrillation
In subjects with renal impairment the dose of generic Betapace should be reduced taking into account the values of creatinine. During pregnancy should only be used in cases of extreme necessity and prior assessment of risk-benefit. Because sotalol is excreted in milk, should consider the potential for adverse reactions in nursing infants in cases of breastfeeding. It was observed adrenergic hyper-reactivity in patients in whom the drug is abruptly interrupted, so it is recommended that the end of the treatment is progressive and gradual over a period of 1 to 2 weeks carefully monitoring (monitoring cardiovascular) the myocardial activity .
Betapace drug interactions
With calcium antagonists: synergism AV conduction and ventricular function. The class I antiarrhythmics (quinidine, procainamide, disopyramide) and class III (amiodarone) should not be associated with sotalol because it can dangerously reduce sympathetic tone, especially during rest. With thiazide diuretics: Hypokalemia or hypomagnesemia may occur, increasing the potential for torsade de pointes. Clonidine: can potentiate the rebound hypertension, especially when suspending clonidine, so the beta-blocker should be withdrawn several days before the withdrawal of clonidine. Insulin and oral hypoglycemic agents: may present hypoglycemia or hyperglycemia and this requires a careful adjustment of these antidiabetics. B 2 agonists (salbutamol, isoprenaline, terbutaline) may increase their serum concentrations when combined with sotalol.Antiarrítmicos (class I), phenothiazine neuroleptics and tricyclic antidepressants should be used with caution when associated with sotalol because they can generate severe arrhythmias (AV block, severe bradycardia), because it prolongs the QT interval.
EPOC. Bronchial asthma. Bradyarrhythmias, cardiogenic shock, heart failure. AV Block degree greater than 2. Renal failure. Long QT syndrome, congenital or acquired. Hypersensitivity to the drug. Safety and efficacy in patients under 18 years have not been established.