When You Can't Get Sotylize, You Need a Plan

If you or a loved one depends on Sotylize (Sotalol hydrochloride oral solution) to manage a heart rhythm disorder, running into a supply issue is more than an inconvenience — it's a medical concern. Antiarrhythmic medications like Sotalol help prevent dangerous heart rhythms, and skipping doses is not a safe option.

In this guide, we'll explain what Sotylize is, how it works, and walk through real alternatives your doctor may consider if you can't fill your prescription.

What Is Sotylize?

Sotylize is the brand-name oral solution form of Sotalol hydrochloride, dosed at 5 mg/mL. It belongs to a class of drugs called Class III antiarrhythmics and also functions as a non-selective beta-blocker.

Sotylize is FDA-approved for two main uses:

• Treating life-threatening ventricular arrhythmias such as ventricular tachycardia
• Maintaining normal sinus rhythm in patients with atrial fibrillation or atrial flutter

The oral solution is especially important for patients who cannot swallow tablets — including children and some elderly patients. For a complete overview, see What Is Sotylize? Uses, Dosage, and What You Need to Know.

How Does Sotylize Work?

Sotalol works through two mechanisms:

1. Beta-blockade (Class II effect): It blocks beta-adrenergic receptors in the heart, slowing the heart rate and reducing the heart's workload.
2. Potassium channel blockade (Class III effect): It blocks potassium channels in heart cells, which prolongs the action potential duration and the refractory period. This makes it harder for abnormal electrical signals to trigger arrhythmias.

This dual mechanism is what sets Sotalol apart from pure beta-blockers and from other antiarrhythmics. Learn more in our detailed article: How Does Sotylize Work?

Alternatives to Sotylize

If you can't find Sotylize or Sotalol oral solution, here are the main alternatives your doctor may consider. Important: Never switch medications on your own. All of these require a doctor's evaluation and, in some cases, in-hospital monitoring to start.

1. Sotalol Tablets (Generic, Betapace, Betapace AF, Sorine)

The simplest alternative is switching from the oral solution to Sotalol tablets. The tablets contain the same active ingredient and are far more widely available.

• Who it's good for: Patients who can swallow tablets
• Availability: Widely available as generic; typically costs $10 to $40 for a 30-day supply
• Key consideration: Not suitable for patients who cannot swallow pills (young children, patients with dysphagia)

If tablets are an option, this is usually the easiest path. Your doctor can convert your oral solution dose directly to the equivalent tablet dose.

2. Amiodarone (Cordarone, Pacerone)

Amiodarone is the most widely used antiarrhythmic drug in the world. Like Sotalol, it's a Class III antiarrhythmic, but it also has Class I, II, and IV properties.

• Who it's good for: Patients with both atrial and ventricular arrhythmias, especially those with heart failure or structural heart disease
• Availability: Widely available as generic tablets and IV; typically $15 to $50 per month
• Key considerations: Amiodarone has significant long-term side effects including thyroid dysfunction, pulmonary toxicity, liver toxicity, and skin photosensitivity. It requires regular blood work and monitoring.

3. Dofetilide (Tikosyn)

Dofetilide is a pure Class III antiarrhythmic (potassium channel blocker) used specifically for atrial fibrillation and atrial flutter.

• Who it's good for: Patients with atrial fibrillation/flutter who need rhythm control
• Availability: Available only through a restricted program called T.I.P.S. (Tikosyn In Pharmacy System); typically $200 to $400 per month
• Key considerations: Like Sotalol, Dofetilide must be initiated in a hospital with continuous ECG monitoring for at least 3 days. It carries a risk of QT prolongation and torsades de pointes. Only certified pharmacies can dispense it.

4. Dronedarone (Multaq)

Dronedarone is structurally similar to Amiodarone but was designed to have fewer of its serious side effects.

• Who it's good for: Patients with atrial fibrillation or flutter who are in or have been in sinus rhythm
• Availability: Available as brand-name Multaq; typically $300 to $500 per month without insurance
• Key considerations: Dronedarone is contraindicated in patients with severe heart failure (NYHA Class IV) or permanent atrial fibrillation. It has a boxed warning about increased mortality in patients with severe heart failure.

5. Flecainide (Tambocor)

Flecainide is a Class IC antiarrhythmic used primarily for atrial fibrillation and supraventricular tachycardias.

• Who it's good for: Patients with atrial fibrillation who do not have structural heart disease or coronary artery disease
• Availability: Available as generic; typically $20 to $60 per month
• Key considerations: Flecainide is not safe for patients with structural heart disease, a history of heart attack, or heart failure. It's often used alongside a beta-blocker or calcium channel blocker to prevent rapid ventricular rates.

How to Decide Which Alternative Is Right for You

The right alternative depends on several factors:

• Your specific type of arrhythmia (atrial vs. ventricular)
• Whether you have structural heart disease or heart failure
• Your kidney function (Sotalol is renally cleared)
• Whether you can swallow tablets
• Other medications you're taking (see our guide on Sotylize drug interactions)
• Cost and insurance coverage

Your cardiologist or electrophysiologist is the best person to guide this decision. Do not switch antiarrhythmic medications on your own — these drugs require careful monitoring, and some require in-hospital initiation.

Final Thoughts

Not being able to fill your Sotylize prescription is stressful, but there are real options available. Whether it's switching to Sotalol tablets, trying a different antiarrhythmic, or working with a compounding pharmacy, your doctor can help you find a safe path forward.

In the meantime, use Medfinder to check if Sotylize is available near you — it may be in stock at a pharmacy you haven't tried yet.

For more on finding this medication, read: How to Find Sotylize in Stock Near You.