Betapace (Sotalol Hydrochloride) – Antiarrhythmic and Beta-Blocker | EZ Chemist
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What is Betapace used for
Betapace is a prescription medicine containing Sotalol, used to treat life-threatening ventricular arrhythmias and maintain normal heart rhythm in patients with atrial fibrillation or flutter. It works by blocking specific heart signals and stabilizing heart rhythm.
Generic Name: Sotalol Hydrochloride

Brand Names: Betapace, Sotalol

Available Strengths: 80 mg, 120 mg, 160 mg, 240 mg

Drug Class: Class III Antiarrhythmic / Non-selective Beta-Blocker

Route of Administration: Oral

Prescription Required: Yes
Sotalol Hydrochloride – a non-cardioselective beta-blocker with potassium channel-blocking (class III antiarrhythmic) activity.
Betapace AF (for atrial fibrillation)

Antiarrhythmic beta-blocker

Sotalol Hydrochloride Tablets

Sotalol HCl
Betapace works through a dual mechanism:

Beta-adrenergic blockade (Class II effect):

Reduces heart rate and myocardial oxygen demand

Controls adrenergically driven arrhythmias

Potassium channel blockade (Class III effect):

Prolongs cardiac action potential and repolarization

Stabilizes electrical activity in the heart, especially ventricular tissue
Ventricular Arrhythmias – Life-threatening sustained ventricular tachycardia

Atrial Fibrillation or Atrial Flutter – Maintenance of normal sinus rhythm

Recurrent Arrhythmia Prevention – Long-term rhythm stabilization in patients prone to re-entry circuits or ectopic pacemaker activity
Patient Type Starting Dose Max Dose
Adults with normal renal function 80 mg twice daily Up to 160–240 mg twice daily depending on response and QT monitoring

Titrate gradually in a hospital setting

Adjust dose based on QT interval, renal function, and arrhythmic control

Renal impairment: Adjust dose or dosing interval to prevent drug accumulation

Note: Betapace AF formulation is not interchangeable with Betapace standard due to dosing differences.
Onset of action: 4–6 hours after dose

Half-life: ~12 hours (longer in renal impairment)

Metabolism: Not extensively metabolized; eliminated unchanged via kidneys

Bioavailability: ~90–100% after oral administration
Fatigue

Bradycardia (slow heartbeat)

Dizziness

Shortness of breath

Palpitations
Torsades de Pointes (life-threatening ventricular arrhythmia)

QT prolongation

Heart failure exacerbation

Bronchospasm in patients with asthma/COPD

Electrolyte imbalance
QT Monitoring: Initiate therapy in a hospital setting due to risk of serious arrhythmias

Renal Function Monitoring: Adjust dose based on creatinine clearance

Do not use in:

Congenital or acquired long QT syndrome

Uncontrolled heart failure

Asthma or chronic bronchitis

Serum potassium <4.0 mEq/L

Avoid abrupt withdrawal: May trigger angina or myocardial infarction in ischemic heart disease
Pharmacologic Class: Non-selective Beta-Blocker and Class III Antiarrhythmic

ATC Code: C07AA07

Legal Status: Schedule H (Rx only in India)
Interacting Drug/Class Clinical Effect
Class I or III Antiarrhythmics Additive QT prolongation risk
Diuretics (loop/thiazide) Hypokalemia increases arrhythmia risk
Beta-blockers (other) Additive bradycardia and hypotension
Calcium Channel Blockers Risk of AV block and reduced cardiac output
Antidepressants (e.g., SSRIs) QT prolongation potential

Clinical Studies & Efficacy
CAST Trial: Highlighted importance of initiating sotalol therapy under monitoring due to proarrhythmic risk

SWORD Study: Found increased mortality risk in patients with structural heart disease

Meta-analysis (JACC 2008): Sotalol shown to maintain sinus rhythm effectively in atrial fibrillation patients but requires QT monitoring

FAQs – Betapace (Sotalol)
Q1: What is Betapace used for?
Betapace is prescribed for ventricular and atrial arrhythmias, helping stabilize heart rhythm and reduce risk of sudden cardiac events.

Q2: How does Betapace differ from standard beta-blockers?
Betapace not only blocks beta receptors but also prolongs cardiac repolarization (class III antiarrhythmic effect), unlike traditional beta-blockers.

Q3: Can Betapace be used for atrial fibrillation?
Yes, but Betapace AF formulation should be used specifically for atrial fibrillation. Dose titration is essential to prevent QT prolongation.

Q4: Is Betapace safe in patients with kidney problems?
Sotalol is excreted via kidneys. In renal impairment, dosing must be adjusted to avoid accumulation and QT prolongation.

Q5: Can Betapace cause shortness of breath?
Yes, especially in patients with bronchospastic diseases or if beta-blockade affects lung receptors.

Q6: How often should heart rhythm be monitored?
Close ECG monitoring is necessary during initiation and dose escalation to avoid dangerous arrhythmias.
Store at 20–25°C (68–77°F)

Keep in original packaging to protect from moisture

Keep out of reach of children

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