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.

@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.

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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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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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I was put on amiodarone after my open-heart surgery in 2018.My cardiologist removed ne from Amiodarone after 6 months. Six months later I went into atrial fibrillation on my way to a routine cardiology follow-up. After my cardioversion he started me on 80 mg of Sotalol. That was in March 2019. I have been taking one 80 mg Sotalol two times daily ever since.
My pulse is on the low side, around 48 bpm. This is a concern for every new doctor or nurse who treats me but has not been a problem till this year. In March I came down with pneumonia and had to take antibiotics. At the end of June, I was hospitalized for congestive heart Failor, which probably led to a second bout of Pneumonia in early July. Follow that up in August with COVID-19. That is a lot of reasons for S.O.B.

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@amandaa

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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Where to start. Yes, my cardiologist has been monitoring SOB for some time. Beta blockers have always slowed me down, ditto Diltiazem. Definitely worse now with Sotalol, and she has ordered a CT angio to see whether CAD has progressed, but said that will take months.
Activity is limited by severe OA and joint injuries.
As for Amiodarone, the long term toxic effects seem to rule it out as an alternative; I would like to know more about how that applies in my case. Stroke risk is very high for several reasons and I have abnormal cerebral arteries so the outcome would not be good. I am not trying to be morbid here, these are just the facts.
I am curious about your mention of a care team. What would that look like in this case?

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@david2stansfield

I was put on amiodarone after my open-heart surgery in 2018.My cardiologist removed ne from Amiodarone after 6 months. Six months later I went into atrial fibrillation on my way to a routine cardiology follow-up. After my cardioversion he started me on 80 mg of Sotalol. That was in March 2019. I have been taking one 80 mg Sotalol two times daily ever since.
My pulse is on the low side, around 48 bpm. This is a concern for every new doctor or nurse who treats me but has not been a problem till this year. In March I came down with pneumonia and had to take antibiotics. At the end of June, I was hospitalized for congestive heart Failor, which probably led to a second bout of Pneumonia in early July. Follow that up in August with COVID-19. That is a lot of reasons for S.O.B.

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thanks, David. So sorry about the Covid on top of it all. My family doc (since retired) was constantly checking me for CHF. I am on the same dose of Sotalol as you and wonder whether some of us are just more sensitive to this drug.

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@amandaa

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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Hi @lizzie63, sorry to hear about your issues. I was on Sotalol, had an ablation and no problems for 7 months, then I was again put on Sotolol. I can't say I am having any problems with it other than my heart rate being a little low. I just wanted you to know Sotalol has been good for me. I feel good and I have lost 50 pounds. I hope you get some answers and find something that works well for you! Take care.

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Like Sunny, my HR is a little low, but no other issues. Sotalol works well for me.

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@david2stansfield

Like Sunny, my HR is a little low, but no other issues. Sotalol works well for me.

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I started taking 120 mg of Sotalol in July 2015. It worked well for about 4 years but in 2019 I had almost monthly episodes of AFib so in October 2019 my dosage was increased to 160 mg and that has worked very fine. In the last 10 months I have not experienced AFib.

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@hergiew

I started taking 120 mg of Sotalol in July 2015. It worked well for about 4 years but in 2019 I had almost monthly episodes of AFib so in October 2019 my dosage was increased to 160 mg and that has worked very fine. In the last 10 months I have not experienced AFib.

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I am starting to wonder whether the potential side effects of Sotalol are mitigated by activity. Can I ask whether you are fairly active?
When I say side effects, I am referring to its effects on the other beta receptors in the body, not the heart. The slower HR is the intended effect, I think . . .
Glad to hear it is working so well for you. I seem to need 160 mg, as well.

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@lizzie63

I am starting to wonder whether the potential side effects of Sotalol are mitigated by activity. Can I ask whether you are fairly active?
When I say side effects, I am referring to its effects on the other beta receptors in the body, not the heart. The slower HR is the intended effect, I think . . .
Glad to hear it is working so well for you. I seem to need 160 mg, as well.

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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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