Recommended Dosing & Administration of Sotalol IV in Adults
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 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
Pharmacokinetic profile for oral versus intravenous sotalol initiation
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
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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.