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ANTIARRHYTHMIC AGENT/BETA BLOCKER
Betapace (sotalol hydrochloride) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat documented, life-threatening heart rhythm problems that start in the lower chambers of the heart (ventricular arrhythmias).
These insights are based on 68 comments about Betapace from MyHeartDiseaseTeam members. These are the experiences of a small number of people and are not meant to be medical advice.
Many members said Betapace helped keep their heart rhythm regular or reduced atrial fibrillation episodes.
Some members said Betapace helped maintain a normal sinus rhythm after cardioversion or ablation.
Several members described having more energy, less shortness of breath, or fewer palpitations when their heart rhythm improved.
Starting or restarting Betapace often requires at least a three-day hospital stay with electrocardiogram (ECG) monitoring.
Fatigue is a frequently reported downside and is listed in prescribing information.
Some members said rhythm control became less effective over time or did not fully prevent recurrences.
Betapace is a type of medication called an anti-arrhythmic. It helps control the heart’s rhythm by blocking certain signals that affect heart rate and changing how electrical signals move through the heart. This helps slow the heart rate and control abnormal heart rhythms.
Doctors prescribe Betapace when people have documented, life-threatening ventricular arrhythmias. They also prescribe it to help delay the return of atrial fibrillation or atrial flutter in people who have significant symptoms and whose heart rhythm has already returned to normal.
Betapace comes as a tablet taken by mouth. How often it is taken depends on the condition being treated and how well the kidneys work.
The recommended starting dose of Betapace for adults is 80 milligrams twice daily.
If needed, a doctor may increase the dose by 80 milligrams per day every three days, as long as tests show that the medicine is not causing certain unsafe changes in the heart’s electrical activity.
For most adults with life-threatening ventricular arrhythmias, the total daily dose is 160 to 320 milligrams, divided into two or three doses. Higher doses have been used for some people with serious heart rhythm problems that are difficult to treat.
For adults taking Betapace to help prevent the return of atrial fibrillation or atrial flutter, most people respond well to 120 milligrams twice daily.
People with reduced kidney function may need lower doses or more time between doses.
Treatment must be started or restarted in a hospital or another healthcare facility where the heart can be monitored continuously for at least three days or until the medicine reaches a steady level in the body.
Your healthcare provider will decide the right dose based on your condition, kidney function, and heart tests. Do not change or stop taking Betapace without medical advice.
This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 68 comments about Betapace from MyHeartDiseaseTeam members. They reflect the experiences of a small number of people and are not meant to be medical advice.Members who use Betapace often discuss the importance of close follow-up, especially when starting the medication or adjusting the dose. They also frequently mention watching for fatigue, taking doses consistently, and talking with a heart rhythm specialist about whether Betapace, ablation, or both fit into their treatment plan.
Connect with others who understand life with heart disease. Join MyHeartDiseaseTeam for free.
In clinical studies of sotalol, the most common side effects occurred in about 3 percent to 20 percent of people, depending on the side effect, dose, and study population. These include:
Betapace can cause serious side effects that may require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction.
Legacy Pharma offers the Legacy Patient Program, which provides eligible uninsured and underinsured people in the United States with Betapace at no cost for up to 12 months per calendar year, subject to prescription, income, residency, and insurance requirements.
You can enter your prescription and dosage details through the program’s online registration portal.
To learn more or apply, visit the Legacy Patient Program website or call 866-435-8080.
Before starting Betapace, your doctor will check:
Tell your doctor if you are allergic to sotalol or have had an allergic reaction to Betapace.
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Avoid taking Betapace within two hours of antacids that contain aluminum oxide or magnesium hydroxide.
Do not take Betapace if you have:
If you are taking Betapace for atrial fibrillation or atrial flutter, you should also not take it if your QT interval is longer than 450 milliseconds.
If you miss a dose, take your next dose at the usual time. Do not take two doses at once or take your next dose earlier than scheduled.
If you are pregnant or planning to become pregnant, talk with your doctor about the possible risks of Betapace.
Do not breastfeed while taking Betapace because the medicine passes into breast milk and may cause serious side effects in your baby.
These answers are fact-checked by our editorial staff.
How effective is Betapace for heart rhythm problems?
Clinical studies of sotalol found that it helped delay the return of atrial fibrillation or atrial flutter, which are conditions that cause an abnormal heart rhythm.
In one 12-month study, the median (middle) time until symptoms returned was:
These doses were generally taken twice daily. Some people with reduced kidney function took them once daily.
In another six-month study involving people with long-lasting atrial fibrillation, the median time until the abnormal heart rhythm returned or death occurred was 44 days with placebo and more than 180 days with sotalol.
Not everyone stayed on treatment. In the 12-month study, people taking higher doses were more likely to stop treatment because of side effects.
How long does Betapace take to work for heart rhythm problems?
After taking Betapace by mouth, the medicine usually reaches its highest level in the blood within 2.5 to 4 hours.
When taken twice daily, the medicine usually reaches a steady level in the blood within two to three days, or after about five to six doses.
However, this does not mean that everyone will notice an improvement in their heart rhythm symptoms within that time. The prescribing information does not give an exact time for when symptoms may improve.
Does Betapace interact with other medicines?
Yes. Betapace can interact with other medicines. Some interactions may increase the risk of serious side effects or affect how well the medicine works.
Medicines that may interact with Betapace include:
Tell your doctor about all the medicines you take. Do not start taking any new medicine without talking to your doctor first.
On MyHeartDiseaseTeam, people share their experiences with heart disease, get advice, and find support from others who understand.
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