Buy Betapace Online

Betapace (sotalol hydrochloride)

BOXED WARNING

To minimize risk of arrhythmia, for a minimum of 3 days, place patients initiated or reinitiated on therapy in a facility that can provide cardiac resuscitation and continuous ECG monitoring. Calculate CrCl prior to dosing. Not approved for A-fib or A-flutter; do not substitute for Betapace AF.

OTHER BRAND NAMES

Sorine

THERAPEUTIC CLASS

Beta blocker (group II/III antiarrhythmic)

DEA CLASS

RX

INDICATIONS

Treatment of documented life-threatening ventricular arrhythmias (eg, sustained ventricular tachycardia).

ADULT DOSAGE

Ventricular Arrhythmias

Documented Ventricular Arrhythmias (eg, Sustained Ventricular Tachycardia):

Initial: 80mg bid
Titrate: May increase after appropriate evaluation to 240 or 320mg/day (120-160mg bid); adjust dose gradually, allowing 3 days between dosing increments
Usual: 160-320mg/day in 2 or 3 divided doses

Refractory Ventricular Arrhythmia:
480-640mg/day when benefit outweighs risk

Transferring to Betapace/Sorine:
Withdraw previous antiarrhythmic therapy for a minimum of 2-3 plasma half-lives before initiating therapy
After discontinuation of amiodarone, do not initiate therapy until QT interval is normalized

PEDIATRIC DOSAGE

Ventricular Arrhythmias

Documented Ventricular Arrhythmias (eg, Sustained Ventricular Tachycardia):
<2 Years:
Refer to PI for dosing chart

≥2 Years:
Initial: 30mg/m2 tid (90mg/m2 total daily dose)
Titrate: Allow at least 36 hrs between dose increments; guide titration by response, HR, and QTc
Max: 60mg/m2

Reduce dose or d/c if QTc >550 msec

Transferring to Betapace/Sorine:
Withdraw previous antiarrhythmic therapy for a minimum of 2-3 plasma half-lives before initiating therapy
After discontinuation of amiodarone, do not initiate therapy until QT interval is normalized

DOSING CONSIDERATIONS

Renal Impairment
Adults:
CrCl >60mL/min: Dose q12h
CrCl 30-59mL/min: Dose q24h
CrCl 10-29mL/min: Dose q36-48h
CrCl <10mL/min: Dose should be individualized

Pediatrics:
Lower doses or increase intervals between doses

ADMINISTRATION

Oral route

Preparation of Extemporaneous Oral Sol

1. Measure 120mL of simple syrup containing 0.1% sodium benzoate
2. Transfer the syrup to a 6-oz amber plastic (polyethylene terephthalate) prescription bottle
3. Add 5 sotalol 120mg tabs to the bottle. These tabs are added intact; it is not necessary to crush the tabs
4. Shake the bottle to wet the entire surface of the tabs. If the tabs have been crushed, shake the bottle until the endpoint is achieved
5. Allow the tabs to hydrate for at least 2 hrs. After at least 2 hrs have elapsed, shake the bottle intermittently over the course of at least another 2 hrs until the tabs are completely disintegrated
6. The procedure results in a sol containing 5mg/mL of sotalol HCl

HOW SUPPLIED

Tab: (Betapace) 80mg*, 120mg*, 160mg*; (Sorine) 80mg*, 120mg*, 160mg*, 240mg* *scored

CONTRAINDICATIONS

Bronchial asthma, sinus bradycardia, 2nd- and 3rd-degree AV block (unless a functioning pacemaker is present), congenital or acquired long QT syndromes, cardiogenic shock, uncontrolled CHF.

WARNINGS/PRECAUTIONS

May provoke new or worsen ventricular arrhythmias (eg, sustained ventricular tachycardia or ventricular fibrillation). Torsades de pointes, QT interval prolongation, and new or worsened CHF reported. Anticipate proarrhythmic events upon initiation and every upward dose adjustment. Caution in patients with QTc >500 msec on-therapy and consider reducing dose or discontinuing therapy when QTc >550 msec. Avoid with uncorrected hypokalemia or hypomagnesemia. Give special attention to electrolyte and acid-base balance in patients with severe/prolonged diarrhea or with concomitant diuretic drugs. May cause further depression of myocardial contractility and precipitate more severe failure; caution with CHF controlled by digitalis and/or diuretics. Caution with left ventricular dysfunction, sick sinus syndrome associated with symptomatic arrhythmias, and renal impairment (especially with hemodialysis). Caution during the first 2 weeks post-MI; careful dose titration is especially important (eg, in patients with markedly impaired ventricular function). Exacerbation of angina pectoris, arrhythmias, and MI reported after abrupt discontinuation; reduce dose gradually over 1-2 weeks. May unmask latent coronary insufficiency in patients with arrhythmias. Avoid in patients with bronchospastic diseases; use lowest effective dose. Impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures; chronically administered therapy should not be routinely withdrawn prior to major surgery. Patients with a history of anaphylactic reaction to various allergens may have a more severe reaction on repeated challenge and may be unresponsive to usual doses of epinephrine. Caution in patients with diabetes (especially labile diabetes) or with a history of episodes of spontaneous hypoglycemia; may mask premonitory signs of acute hypoglycemia (eg, tachycardia). May mask certain clinical signs (eg, tachycardia) of hyperthyroidism.

ADVERSE REACTIONS

Torsades de pointes, dyspnea, fatigue, dizziness, bradycardia, chest pain, palpitation, asthenia, abnormal ECG, hypotension, headache, light-headedness, edema, N/V, pulmonary problems.

DRUG INTERACTIONS

Avoid with Class Ia (eg, disopyramide, quinidine, procainamide) and Class III (eg, amiodarone) antiarrhythmics. Additive Class II effects with other β-blockers. Proarrhythmic events were more common with digoxin. May increase risk of bradycardia with digitalis glycosides. Possible additive effects on AV conduction or ventricular function and BP with calcium-blocking agents. May produce excessive reduction of resting sympathetic nervous tone with catecholamine-depleting drugs (eg, reserpine, guanethidine). Hyperglycemia may occur; may require dose adjustment of insulin or antidiabetic agents. β2-agonists (eg, salbutamol, terbutaline, isoprenaline) may need dose increase. May potentiate rebound HTN with clonidine withdrawal. Avoid administration within 2 hrs of antacids containing aluminum oxide and magnesium hydroxide; may reduce levels. Caution with drugs that prolong QT interval (eg, Class I and III antiarrhythmics, phenothiazines, TCAs, astemizole, bepridil, certain oral macrolides, certain quinolone antibiotics).

PREGNANCY AND LACTATION

Category B, not for use in nursing.

MECHANISM OF ACTION

β-blocker (group II/III antiarrhythmic); has both β-adrenoreceptor blocking and cardiac action potential duration prolongation properties.

PHARMACOKINETICS

Absorption: Bioavailability (90-100%); Tmax=2.5-4 hrs. Distribution: Crosses placenta; found in breast milk. Elimination: Urine (unchanged); T1/2=12 hrs.

ASSESSMENT

Assess for hypersensitivity to drug, bronchial asthma, sinus bradycardia, sick sinus syndrome, 2nd- and 3rd-degree AV block, pacemaker, long QT syndromes, cardiogenic shock, left ventricular dysfunction or uncontrolled CHF, recent MI, ischemic heart disease, hypokalemia or hypomagnesemia, bronchospastic disease, diabetes, episodes of hypoglycemia, upcoming major surgery, hyperthyroidism, renal impairment, any other conditions where treatment is contraindicated or cautioned, pregnancy/nursing status, and possible drug interactions.

MONITORING

Monitor for ECG changes, tachycardia, arrhythmias, depressed myocardial contractility, severe CHF, anaphylaxis, hypoglycemia, electrolyte imbalance, hyperthyroidism, and other adverse reactions.

PATIENT COUNSELING

Inform of the benefits/risks of therapy. Advise not to d/c therapy without consulting physician. Instruct to report any adverse reactions to physician.

STORAGE

(Betapace) 25°C (77°F); excursions permitted to 15-30°C (59-86°F). (Sorine) 15-30°C (59-86°F). Sus: Stable for 3 months at 15-30°C (59-86°F) and ambient humidity.

TAGS

buy betapace, purchase sotalol online, sotalol hydrochloride (betapace), ␢ sotalol betapace, sotalol betapace 80 mg, sotalol betapace side effects, purchase sotalol, order sotalol, betapace af vs sotalol, order sotalol online, sotalol betapace, betapace sotalol cost, buy sotalol, side effects sotalol oral betapace, sotalol betapace af, betapace sotalol, buy sotalol online, betapace 160 mg, betapace sotalol side effects, generic sotalol, betapace vs sotalol