For US Healthcare Professionals Only

Currently Viewing: 

Recommended Dosing & Administration of Sotalol IV in Adults

I'm looking for information on dosing & administration for...

1-Day Initiation* of Atrial Fibrillation (AFib), Atrial Flutter (AFL), & Ventricular Tachycardia (V-Tach) Sotalol Therapy¹

Intravenous sotalol therapy can be initiated for 80mg or 120mg oral dosing, and escalated from 80 to 120 or 120 to 160mg.

All initiations and dose escalations utilize a Sotalol IV infusion of 1 hour.

The intravenous loading dose depends on the target oral dose and Glomerular Filtration Rate (GFR); the dosing interval for oral administration of sotalol and the minimum delay between the end of the infusion and the first oral dose also depend on renal function.

Recommended Loading Dosage in Adults

Recommended Loading Dosage in Adults

Recommended Monitoring

  • Monitor QTc interval every 15 minutes during infusion
  • Continue to monitor QTc at peak serum concentration after each oral dose (2 to 4 hours post-dose)

Example 24-hour treatment protocol for sotalol initiation

1 day timeline with Sotalol IV initiation

Pharmacokinetic profile for oral versus intravenous sotalol initiation

Sotalol pharmacokinetics comparison chart

Substitution of Oral Sotalol¹

Intravenous sotalol therapy can be used as a substitute for oral sotalol in patients unable to take oral medication.

To match the exposure to oral sotalol, intravenously infuse the adjusted dose at the same dosing frequency as the oral dose based on glomerular filtration rate over 5 hours.

Intravenous Infusion Dosages of Sotalol in Adults Administered Over 5 Hours Based on Oral Sotalol Dose and GFR

Intravenous Infusion Dosages of Sotalol in Adults Administered Over 5 Hours Based on Oral Sotalol Dose and Glomerular Filtration Rate

Do you also treat pediatric patients?

Learn more about using Sotalol IV in pediatric populations.

Connect with the AltaThera team.

Contact us today

We're here to answer your questions about intravenous sotalol, assist in staff training, and more, virtually or in-person.

Send us a message

*Discharge depends on clinical evaluation, renal function, and response to therapy. Patients with GFR ≥ 60 mL/min may be discharged within 20-24 hours; however, timing may vary.

Recommended starting dose

REFERENCES
1 Sotalol IV [package insert]. Chicago, IL: AltaThera Pharmaceuticals; 07/2025.
2 BetaPace AF (sotalol hydrochloride) [Full Prescribing Information]. Zug, CH: Covis Pharma; 06/2023.

This website is intended for US healthcare professionals only.

By selecting an option below, you certify that you are a licensed US healthcare professional and wish to view information regarding Sotalol IV (sotalol hydrochloride injection). 

I’m using Sotalol IV in…

View adult website

View pediatric website

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.