Also indexed as: Betapace
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
 May Be Beneficial: Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication. |
Magnesium
|
Avoid: Reduced drug absorption/bioavailability—Avoid these supplements
when taking this medication since the supplement may decrease the absorption and/or activity
of the medication in the body. |
Antacids
Calcium supplements
Food
Milk
|
|
Avoid: Adverse interaction—Avoid these supplements when taking this
medication because taking them together may cause undesirable or dangerous results. |
High-potassium foods*
Pleurisy root*
Potassium (low)
Potassium supplements*
|
| Depletion or interference |
None known
|
| Supportive interaction |
None known
|
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions with Dietary Supplements
Calcium
One controlled study showed that taking sotalol with a calcium gluconate solution dramatically
reduces the absorption of the drug.1 Consequently, people who take a calcium
supplement should take sotalol an hour before or two hours after the calcium.
Magnesium
Two individuals taking sotalol developed a side effect of the drug (a heart arrhythmia known
as torsades de pointes) which was effectively treated with intravenous magnesium.2
3 Additional research is needed to determine whether people taking sotalol might be
able to prevent this side effect by taking supplemental magnesium.
Potassium
People with prolonged diarrhea and vomiting,
as well as those taking potassium-depleting
diuretics, might develop low blood potassium levels. Individuals with low blood potassium
levels who take sotalol have an increased risk of developing a serious heart arrhythmia and fainting. Therefore, people taking
sotalol should have their blood potassium levels checked regularly and may need to supplement
with potassium, especially when taking potassium-depleting diuretics.
Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease
the uptake of potassium from the blood into the cells,4 leading to excess potassium
in the blood, a potentially dangerous condition known as hyperkalemia.5 People
taking beta-blockers should therefore avoid taking potassium supplements, or eating large
quantities of fruit (e.g., bananas), unless directed to do so by their
doctor.
Interactions with Herbs
Pleurisy
root
As pleurisy root and other plants in the Aesclepius genus contain cardiac glycosides,
it is best to avoid use of pleurisy root with heart medications such as
beta-blockers.6
Interactions with Foods and Other Compounds
Food
Taking sotalol with food gretly reduces the absorption of the drug.7 One study
showed that taking sotalol with milk also
decreases absorption.8 Therefore, sotalol should be taken an hour before or two
hours after a meal or milk.
Antacids
Taking sotalol within two hours of antacids containing aluminum oxide and magnesium hydroxide dramatically reduces the
absorption of the drug. Antacids that contain calcium carbonate might also reduce
absorption.9 Consequently, if antacids are being used, sotalol should be taken one
hour before or two hours after the antacids.
References:1. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food
constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol
(Copenh) 1979;44:7–12.
2. Sasse M, Paul T, Bergmann P, Kallfelz HC. Sotalol associated torsades
de pointes tachycardia in a 15-month-old child: successful therapy with magnesium aspartate.
Pacing Clin Electrophysiol 1998;21:1164–6.
3. Arstall MA, Hii JT, Lehman RG, Horowitz JD. Sotalol-induced torsade de
pointes: management with magnesium infusion. Postgrad Med J 1992;68:289–90.
4. Rosa RM, Silva P, Young JB, et al. Adrenergic modulation of extrarenal
potassium disposal. N Engl J Med 1980;302:431–4.
5. Lundborg P. The effect of adrenergic blockade on potassium
concentrations in different conditions. Acta Med Scand Suppl 1983;672:121–6
[review].
6. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide
for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213–4.
7. Sifton DW, ed. Physicians’ Desk Reference. Montvale,
NJ: Medical Economics Company, Inc., 2000, 741–5.
8. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food
constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol
(Copenh) 1979;44:7–12.
9. Laer S, Neumann J, Scholz H. Interaction between sotalol and an
antacid preparation. Br J Clin Pharmacol 1997;43:269–72.