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

Interested in more discussions like this? Go to the Heart Rhythm Conditions group.

@aharders Hi there and welcome to Mayo Clinic Connect.

According to the NIH, There is no significant difference between amiodarone and sotalol in converting atrial fibrillation to sinus rhythm. However, amiodarone is more effective in maintenance of sinus rhythm than sotalol. The adverse reaction of amiodarone on heart is less severe than that of sotalol. https://pubmed.ncbi.nlm.nih.gov/16620720/

Here is a study that the New England Journal of Medicine did where they compared the two.
https://www.nejm.org/doi/full/10.1056/NEJMoa041705
@lucky1038, @ashby1947 and @danab has taken one or both. I would like to invite them to the conversation to weigh in.

Which medicine are you currently taking and do you have a-fib?

REPLY

@aharders Hi and Welcome to Connect. Great Question and I was only on one of them Amiodroine. I'll start by saying that this is at least by most Doctors I've spoken to the best med for Arithmias . I had the more fatal type of arrhythmia called Vintricular Tachycardia or VT for short. It affects the lower part of the Heart and when an attack comes you have minutes to react hence the reason I had a pacemaker/defibrillator also. So based on that background I was on it about 10 years but there are side affects with long term use and due to a failing Heart I was hospitalized many times. Usually until some adjustments could be made either with an ablation or med changes they would put me on the IV type of Amiodronine and it was usually successful. Well what prompted my Heart Transplant is that medicine started to become toxic to me ,at the end I had to be removed from it and that prompted the transplant. Also a couple of side affects along the way was it damaged my thyroid and it had to be removed. I actually also ,over the 10 years, developed a blue tint to my ears. I didn't notice it myself until my doctor pointed it out as common with Amiodroine. So great medicine but not the best for long term use particularly in higher doses. Now realize this i was on the stronger IV type so I'm not positive pill form would have caused the toxicity. But in my case it was the IV version called a different name it sounded like lanicane I believe but not the stuff used as a local anesthesia. So ask your doctor about some of this and I hope you can get some information on the other one.
Blessings

REPLY
@danab

@aharders Hi and Welcome to Connect. Great Question and I was only on one of them Amiodroine. I'll start by saying that this is at least by most Doctors I've spoken to the best med for Arithmias . I had the more fatal type of arrhythmia called Vintricular Tachycardia or VT for short. It affects the lower part of the Heart and when an attack comes you have minutes to react hence the reason I had a pacemaker/defibrillator also. So based on that background I was on it about 10 years but there are side affects with long term use and due to a failing Heart I was hospitalized many times. Usually until some adjustments could be made either with an ablation or med changes they would put me on the IV type of Amiodronine and it was usually successful. Well what prompted my Heart Transplant is that medicine started to become toxic to me ,at the end I had to be removed from it and that prompted the transplant. Also a couple of side affects along the way was it damaged my thyroid and it had to be removed. I actually also ,over the 10 years, developed a blue tint to my ears. I didn't notice it myself until my doctor pointed it out as common with Amiodroine. So great medicine but not the best for long term use particularly in higher doses. Now realize this i was on the stronger IV type so I'm not positive pill form would have caused the toxicity. But in my case it was the IV version called a different name it sounded like lanicane I believe but not the stuff used as a local anesthesia. So ask your doctor about some of this and I hope you can get some information on the other one.
Blessings

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Many thanks

REPLY

I have been on Sotalol for several years. I had an ablation 1 year ago and successfully had no AFIB for 7 months. When I had 5 AFIB events in one month, I was put back on the Sotalol which seems to be working well for me so far. The side effects that I have had with this medicine have been mild muscle aches. I try to do cardio exercise 5 days a week for 60 minutes if my schedule allows and I am doing well.

REPLY
@danab

@aharders Hi and Welcome to Connect. Great Question and I was only on one of them Amiodroine. I'll start by saying that this is at least by most Doctors I've spoken to the best med for Arithmias . I had the more fatal type of arrhythmia called Vintricular Tachycardia or VT for short. It affects the lower part of the Heart and when an attack comes you have minutes to react hence the reason I had a pacemaker/defibrillator also. So based on that background I was on it about 10 years but there are side affects with long term use and due to a failing Heart I was hospitalized many times. Usually until some adjustments could be made either with an ablation or med changes they would put me on the IV type of Amiodronine and it was usually successful. Well what prompted my Heart Transplant is that medicine started to become toxic to me ,at the end I had to be removed from it and that prompted the transplant. Also a couple of side affects along the way was it damaged my thyroid and it had to be removed. I actually also ,over the 10 years, developed a blue tint to my ears. I didn't notice it myself until my doctor pointed it out as common with Amiodroine. So great medicine but not the best for long term use particularly in higher doses. Now realize this i was on the stronger IV type so I'm not positive pill form would have caused the toxicity. But in my case it was the IV version called a different name it sounded like lanicane I believe but not the stuff used as a local anesthesia. So ask your doctor about some of this and I hope you can get some information on the other one.
Blessings

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Amiridione didnt work for me, I am on Digoxin and Meteproprol. I have been doing great.

REPLY
@sunny617

I have been on Sotalol for several years. I had an ablation 1 year ago and successfully had no AFIB for 7 months. When I had 5 AFIB events in one month, I was put back on the Sotalol which seems to be working well for me so far. The side effects that I have had with this medicine have been mild muscle aches. I try to do cardio exercise 5 days a week for 60 minutes if my schedule allows and I am doing well.

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Thanks for your thoughtful response.

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@hmccarth5

Amiridione didnt work for me, I am on Digoxin and Meteproprol. I have been doing great.

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Glad to hear they work for you.

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@hmccarth5

Amiridione didnt work for me, I am on Digoxin and Meteproprol. I have been doing great.

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Muchos thankos

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@amandaa

@aharders Hi there and welcome to Mayo Clinic Connect.

According to the NIH, There is no significant difference between amiodarone and sotalol in converting atrial fibrillation to sinus rhythm. However, amiodarone is more effective in maintenance of sinus rhythm than sotalol. The adverse reaction of amiodarone on heart is less severe than that of sotalol. https://pubmed.ncbi.nlm.nih.gov/16620720/

Here is a study that the New England Journal of Medicine did where they compared the two.
https://www.nejm.org/doi/full/10.1056/NEJMoa041705
@lucky1038, @ashby1947 and @danab has taken one or both. I would like to invite them to the conversation to weigh in.

Which medicine are you currently taking and do you have a-fib?

Jump to this post

Sotalol and only one (very brief) episode since taking it.

REPLY

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?

REPLY
@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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Hi I’m on sotolol too. I’ve gained 10 lbs since the dr increased it and I’m having stomach issues. Dr said if I have an ablation I could possibly get off this med. It helps me from going through atrial fibrillation.

REPLY
@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?

Jump to this post

Hi @lizzie63, happy to have you. There are several people here on Connect that are taking Sotalol, so I moved your post to this discussion:
Side Effects: Amiodarone vs Sotalol
https://connect.mayoclinic.org/discussion/amiodarone-vs-sotalol/
Allow me to introduce you to @sunny617 who is active and also on sotalol.

Have you discussed with anyone on your care team about the SOB the medication is causing you?

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