amiodarone vs sotalol
Side-by-side comparison of amiodarone and sotalol. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
moderate Known Drug Interaction
Class Ia antiarrhythmic drugs, such as disopyramide, quinidine, and procainamide, and other Class III drugs (for example, amiodarone) are not recommended as concomitant therapy with sotalol hydrochloride, because of their potential to prolong refractoriness [see Warnings and Precautions ( 5.2 )].
Recommendation: This combination is not recommended. Your doctor should avoid prescribing these two heart rhythm medications at the same time to ensure your heart rhythm stays stable.
Cordarone, Pacerone
Betapace
Amiodarone (Pacerone) is a medicine used to treat life-threatening, irregular heartbeats. It helps to restore a normal heart rhythm when other medicines don't work or can't be used.
Sotalol is a medicine that helps keep your heart beating regularly. It can treat dangerous fast heartbeats and help prevent irregular heartbeats from coming back.
This medicine treats very fast, irregular heartbeats in the ventricles (lower chambers of the heart). It is used when these irregular heartbeats are life-threatening. It is also used when other medicines don't work well enough or cause too many side effects. This medicine is for adults.
Sotalol is used to treat life-threatening fast heartbeats in the lower chambers of the heart. It is also used to help keep a normal heart rhythm in people with atrial fibrillation or flutter, which are types of irregular heartbeats in the upper chambers of the heart. Sotalol is for people who have very bothersome symptoms from their atrial fibrillation or flutter.
Amiodarone affects the electrical signals in your heart. It slows down these signals, which helps your heart beat normally. This medicine can help prevent dangerous, fast heart rhythms.
Sotalol works by slowing down the electrical signals in your heart. It has two actions: it blocks beta receptors (like a beta-blocker) and it prolongs the action potential duration in the heart. This helps to stabilize your heart rhythm and prevent irregular heartbeats.
- • Low thyroid levels (hypothyroidism)
- • High thyroid levels (hyperthyroidism)
- • Heart failure
- • Irregular heartbeats
- • Problems with the heart's natural pacemaker (SA node dysfunction)
- • Feeling tired
- • Slow heart rate (less than 50 bpm)
- • Shortness of breath
- • New or worsening irregular heartbeats
- • Weakness
- Difficulty breathing 1,158
- Weakness 975
- Tiredness 893
- Feeling sick to your stomach 605
- Coughing 597
- Irregular heartbeat 1,178
- Shortness of breath 912
- Tiredness 867
- Feeling lightheaded 734
- Loose stool 719
This medicine can cause serious problems with your lungs, liver, and heart. Lung problems can be fatal. Your doctor will check your lungs with X-rays and breathing tests. Liver problems can also be fatal. Your doctor will check your liver with blood tests. This medicine can also make irregular heartbeats worse. You will likely start this medicine in the hospital where your heart can be monitored.
Sotalol can cause life-threatening irregular heartbeats. To lower this risk, you will start or restart sotalol in a hospital where your heart can be monitored. If your QT interval (a measure on your heart tracing) gets too long (500 msec or greater), your doctor may lower your dose or stop the medicine. Your doctor will check your kidney function to decide the right dose for you.
This medicine can harm your unborn baby. It can cause thyroid problems, slow heart rate, and brain development issues. Do not breastfeed while taking this medicine.
Sotalol can harm your unborn baby, so talk to your doctor if you are pregnant or plan to become pregnant. Sotalol can pass into breast milk and may harm a nursing infant, so do not breastfeed while taking sotalol.
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How to Read This amiodarone vs sotalol Comparison
amiodarone is classified in the Class III Antiarrhythmic drug class, while sotalol sits within the Class III Antiarrhythmic / Beta-Blocker class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, amiodarone has 4,228 submissions while sotalol has 4,410. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known moderate interaction flagged in FDA labeling, attributed to both drugs affect the electrical timing of your heartbeat in the same way. taking them together can cause the heart's resting phase to last too long, which increases the risk of life-threatening heart rhythm problems.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between amiodarone and sotalol - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.