Two medicines, side by side
Sotalol vs propranolol
Sotalol and propranolol are both labeled for atrial fibrillation. Drugs@FDA records approvals of sotalol since 1992 and of propranolol since 1967. Pharmacies paid $0.0707 per sotalol 80 mg tablet and $0.0493 per propranolol 20 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Sotalol's other strengths are brand-only: $2.32 per mL (Sotylize 5 mg/mL oral solution). In FDA's classes, sotalol is an antiarrhythmic and propranolol a beta-adrenergic blocker.
Check it at the source: the sotalol FDA label on DailyMed (effective December 16, 2024); the propranolol FDA label on DailyMed (effective January 15, 2026).
Highlights of the sotalol record
Sotalol (Betapace) · label of December 16, 2024
LIFE-THREATENING PROARRHYTHMIA To minimize the risk of drug-induced arrhythmia, initiate or reinitiate oral sotalol in a facility that can provide cardiac resuscitation and continuous electrocardiographic monitoring. Sotalol can cause life-threatening ventricular tachycardia associated with QT interval prolongation. If the QT interval prolongs to 500 msec or greater, reduce the dose, lengthen the dosing interval, or discontinue the drug.
Used for
From the label: indicationsBetapace/Betapace AF is an antiarrhythmic indicated for: the treatment of life-threatening ventricular arrhythmias ( 1.1 ) the maintenance of normal sinus rhythm in patients with atrial fibrillation or flutter (AFIB/AFL) ( 1.2 ) Limitations of Use Betapace has not been shown to enhance survival in patients with life threatening ventricular arrhythmias ( 1.1 ) Avoid use in patients with minimally symptomatic or […]
On the market
- Earliest approval on file
- October 30, 1992
- Generic labelers
- 18 labelers
- Pharmacy cost
- $0.0707 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 1
Highlights of the propranolol record
Propranolol (Inderal) · label of January 15, 2026
Used for
From the label: indicationsHypertension Propranolol hydrochloride tablets are indicated in the management of hypertension. It may be used alone or used in combination with other antihypertensive agents, particularly a thiazide diuretic. Propranolol hydrochloride tablets are not indicated in the management of hypertensive emergencies. […]
On the market
- Earliest approval on file
- November 13, 1967
- Generic labelers
- 42 labelers
- Pharmacy cost
- $0.0493 per tablet
Supply and safety
- Shortage
- In shortage
- Recalls
- 4
Source: FDA drug labels via openFDA (Sotalol label of December 16, 2024, Propranolol label of January 15, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do sotalol and propranolol differ on the record?
In FDA's classes, sotalol is an antiarrhythmic and propranolol a beta-adrenergic blocker.
How each works, in its label's words: Sotalol, “Sotalol has both beta-adrenoreceptor blocking (Vaughan Williams Class II) and cardiac action potential duration prolongation (Vaughan Williams Class III) antiarrhythmic properties.”; Propranolol, “Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established.”
Half-life, in each label's words: Sotalol, “The mean elimination half-life of sotalol is 12 hours.”; Propranolol, “The plasma half-life of propranolol is from 3 to 6 hours.”
Only the sotalol label carries a boxed warning.
Generics: sotalol since 2000; propranolol since 1985 (Drugs@FDA).
| Sotalol | Propranolol | |
|---|---|---|
| Labeled for | Atrial fibrillation | High blood pressure, Angina, Atrial fibrillation, Migraine |
| Pharmacologic class | Antiarrhythmic | beta-Adrenergic Blocker |
| How it works (label) | Sotalol has both beta-adrenoreceptor blocking (Vaughan Williams Class II) and cardiac action potential duration prolongation (Vaughan Williams Class III) antiarrhythmic properties. | Mechanism of Action The mechanism of the antihypertensive effect of propranolol has not been established. |
| Half-life (label) | The mean elimination half-life of sotalol is 12 hours. | The plasma half-life of propranolol is from 3 to 6 hours. |
| Earliest approval on file (Drugs@FDA) | October 30, 1992 | November 13, 1967 |
| First generic approved | May 1, 2000 | July 30, 1985 |
| Generic labelers (NDC) | 18 labelers | 42 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0707 per tablet (Sotalol 80 mg tablet) | $0.0493 per tablet (Propranolol 20 mg tablet) |
| 12-month price change | +0.9% | -17% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | In shortage |
| Recalls recorded | 1 | 4 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 16,549 | 71,660 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to sotalol
- every medicine labeled for the same conditions