Side Effects: Amiodarone vs Sotalol

Posted by aharders @aharders, Oct 24, 2021

Can anyone direct me to a relatively comprehensive comparison of these two? TIA

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@hergiew

I don't know whether an active life impacts the effectiveness of sotalol. I have been very active most of my life, ran regularly including a couple of marathons years ago, currently still Golf and go to exercise class 4 days a week at the senior community in which we live and walk some other days. I participated in and started many organizations like golf group, breakfast group, St John's University alumni group, men's group, Bridge group, Etc. I do not know whether that positively impacts the effectiveness of Sotalol.

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Thanks for your reply. I was thinking specifically of physical activity and I think you are confirming my hypothesis. Though I have no doubt that the other activities are beneficial, as well. I am still able to engage in lots of the other, just not much of the physical. But I am encouraged to keep trying. I wonder whether anyone is researching this question: are the effects of Sotalol on non-cardio beta receptors mitigated by physical exercise. A question for @amandaa, perhaps.

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@lizzie63

Sotalol has done a good job of managing my atrial fibrillation for a few months now but it may be blocking the beta receptors in adipose tissue and perhaps the pancreas, as well as in the heart. Amiodarone is the only other AF drug available in Canada if you have CAD and I am not keen on ablation -- and neither are my docs. I am waiting for an endocrinology consult to see whether there is another explanation for the dramatic increase in adipose tissue (without weight gain) and elevated A1C that coincides with Sotalol use. I am also very SOB on Sotalol, and activity is very limited as a result, so deconditioning is also a factor, for sure.Has anyone else had these problems with Sotalol?

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Might I ask why you and your docs are not keen on ablation. I am on Sotalol for my Afib and find myself very tired because of this drug. With Amiodarone I found my Afib to be under control and no tiredness.

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@octobersman

Might I ask why you and your docs are not keen on ablation. I am on Sotalol for my Afib and find myself very tired because of this drug. With Amiodarone I found my Afib to be under control and no tiredness.

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I think I answered your question in my August 18 post so I will just try to summarize now: I also have coronary artery disease and also a very high risk of stroke with likely a severe outcome in the event of stroke. So Sotalol may be the best option for me, the jury is still out . . .

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I don't think ablation is a good option as everyone I know that has had ablation have had several repeats. That is fine for whoever is doing it, but it sure affects your insurance.
I am on Amiodarone, supposed to be on 200mg a day. That kills my energy and caused a lot of other irritations in my daily life. I did a lot of studying and read a paper on the efficiacy of 100mg compared to 200mg. After 18 months I cut the pills in half, 100mg a day. Feel a lot better but still wary of this drug. My primary calls it poison and my cardiologist wants me to switch to Sotalol. I might not be a doctor but I can read and my comprhension skills are good. I personally am holding off on that switch which would require that I stop Metoprolol 2 x 100mg and the Amiodarone and go on bidaily Sotalol.
It's all poison. My current regimen is 2.5mg Amlodipine, 200mg Metoprolol and 120mg Verapamil and 100mg Amiodaroneper day. I think I am starting to get blurred vision and last US shows Pancreatic issues.

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