For US Healthcare Professionals

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Liu AY, Charron J, Fugaro D, et al.  Implementation of an intravenous sotalol initiation protocol: Implications for feasibility, safety, and length of stay. J Cardiovasc Electrophysiol. 2023; 34:502‐506. doi:10.1111/jce.15819

In their March 2023 publication in the Journal of Cardiovascular Electrophysiology, Dr. Albert Liu et al reviewed data from 29 patients who were initiated on intravenous sotalol to examine feasibility, safety and length of stay for Sotalol IV.  IV sotalol loading had a safety profile similar to that of oral sotalol, while shortening length of stay (1.0 vs. 3.6 days for oral sotalol), potentially leading to large cost savings. https://pubmed.ncbi.nlm.nih.gov/36640424/

Highlights of Prescribing Information

Boxed Warning, Indications, and Important Safety Information

WARNING: LIFE THREATENING PROARRHYTHMIA

Sotalol can cause life threatening ventricular tachycardia associated with QT interval prolongation. To minimize the risk of drug induced arrhythmia, initiate or uptitrate intravenous sotalol in a facility that can provide continuous electrocardiographic monitoring and cardiac resuscitation [see Dosage and Administration (2.3) and Warnings and Precautions (5.1)].
Do not initiate intravenous sotalol therapy if the baseline QTc is longer than 450 ms. If the QTc prolongs to 500 ms or greater, reduce the dose or discontinue. (2.3)