What Is Sotylize?

Sotylize is the brand name for Sotalol hydrochloride oral solution, a prescription medication used to treat serious heart rhythm disorders. It is manufactured by AltaThera Pharmaceuticals and comes as a liquid (5 mg/mL) that is taken by mouth.

Sotalol has been available for decades in tablet form under brand names like Betapace, Betapace AF, and Sorine. Sotylize provides the same active ingredient in a liquid formulation, which is especially useful for patients who cannot swallow pills — including children with heart rhythm problems.

What Is Sotylize Used For?

Sotylize is FDA-approved for two main uses:

1. Treatment of life-threatening ventricular arrhythmias — specifically ventricular tachycardia, a condition where the lower chambers of the heart beat too fast, which can be fatal if not controlled.
2. Maintenance of normal sinus rhythm — in patients with highly symptomatic atrial fibrillation (AFib) or atrial flutter (AFL) who are currently in sinus rhythm. This means Sotylize helps prevent these abnormal rhythms from returning.

Doctors may also use Sotalol off-label for rate control in atrial fibrillation, prevention of supraventricular tachycardia (SVT), and ventricular arrhythmia prevention after a heart attack.

How Does Sotylize Work?

Sotylize belongs to two drug classes at the same time:

• Class II antiarrhythmic (beta-blocker) — It blocks beta-adrenergic receptors in the heart, which slows the heart rate and reduces the heart's workload.
• Class III antiarrhythmic — It blocks potassium channels in the heart, which prolongs the action potential duration and helps stabilize the heart's electrical rhythm.

This dual action makes Sotalol unique among antiarrhythmic drugs. For a more detailed explanation, read our article on how Sotylize works.

Dosage and How to Take Sotylize

Typical Dosage

The typical starting dose of Sotalol for adults is 80 mg twice daily. Your doctor may gradually increase the dose based on your response and ECG monitoring. The maximum dose depends on the condition being treated:

• Ventricular arrhythmias: Up to 320 mg twice daily
• Atrial fibrillation/flutter: Up to 160 mg twice daily

Sotylize oral solution is dosed at 5 mg/mL, which allows for flexible and precise dosing — especially important for pediatric patients whose doses are calculated by body weight and age.

How to Take It

• Take Sotylize by mouth twice daily.
• Use the oral syringe provided with the medication to measure your exact dose.
• You can take it with or without food, but try to be consistent with timing.
• Take doses approximately 12 hours apart.
• Do not stop taking Sotylize without talking to your doctor first.

Dose Adjustments

Your dose may be adjusted based on:

• QTc interval — Your doctor will monitor your ECG. If the QTc interval becomes too prolonged (500 ms or more), the dose will be reduced or the drug discontinued.
• Kidney function — Sotalol is cleared by the kidneys. If your kidney function is reduced, you will need a lower dose or longer intervals between doses. Sotylize is contraindicated if creatinine clearance is below 40 mL/min for the atrial fibrillation indication.

Important Safety Information

Boxed Warning

Sotylize carries the FDA's most serious warning. Key points:

• Patients must be started on Sotylize (or restarted after a gap) in a hospital or clinical facility that can provide continuous ECG monitoring, cardiac resuscitation, and creatinine clearance testing for a minimum of 3 days.
• Sotalol can cause torsades de pointes, a life-threatening type of ventricular tachycardia linked to QT prolongation.
• Do not start Sotylize if your baseline QTc is greater than 450 ms.

Who Should Not Take Sotylize

Sotylize is contraindicated in patients with:

• Sinus bradycardia (resting heart rate below 50 bpm)
• Second- or third-degree AV block without a pacemaker
• Congenital or acquired long QT syndrome
• Cardiogenic shock
• Uncontrolled heart failure
• Low potassium (below 4 mEq/L)
• Bronchial asthma or severe bronchospastic conditions
• Severe kidney impairment (CrCl below 40 mL/min for AFib; below 10 mL/min for ventricular arrhythmias)

Special Populations

• Children: Sotylize oral solution is particularly useful for pediatric patients. Dosing is based on body weight and age, and must be supervised by a pediatric cardiologist.
• Elderly: Start at the lower end of the dosing range. Older adults are at higher risk for bradycardia, dizziness, and falls.
• Pregnancy: Sotalol is Pregnancy Category B. Use only if the benefit clearly outweighs the risk. Discuss with your doctor.
• Kidney disease: Dose adjustments are essential. Your doctor will calculate your creatinine clearance to determine the right dose.

Side Effects Overview

Common side effects include fatigue, dizziness, slow heart rate, shortness of breath, nausea, and headache. Serious side effects include QT prolongation, torsades de pointes, heart failure worsening, severe bradycardia, and bronchospasm. For a full breakdown, read our Sotylize side effects guide.

Drug Interactions

Sotylize interacts with several other medications, particularly other drugs that prolong the QT interval, calcium channel blockers, and digoxin. Antacids may reduce absorption. For the complete list, see our drug interactions guide.

Available Forms of Sotalol

Sotalol is available in several forms:

• Sotylize oral solution: 5 mg/mL (brand)
• Generic Sotalol tablets: 80 mg, 120 mg, 160 mg, 240 mg
• Brand tablets: Betapace, Betapace AF, Sorine

The oral solution (Sotylize) is the only commercially available liquid form, making it essential for patients who need precise liquid dosing. If you are having trouble finding it, check our guides on checking pharmacy stock and why Sotylize is hard to find.

Cost and Savings

Sotylize brand oral solution can cost between $300 and $600 for a 30-day supply without insurance. Generic Sotalol tablets are much more affordable at $10 to $40 per month. If cost is a concern, explore our guide on how to save money on Sotylize, which covers coupons, patient assistance programs, and manufacturer savings.

The Bottom Line

Sotylize is a critical medication for patients with serious heart rhythm disorders who need a liquid form of Sotalol. It is effective but comes with important safety requirements, including mandatory in-hospital initiation and ongoing ECG monitoring. If you have been prescribed Sotylize, work closely with your cardiologist or electrophysiologist to ensure safe and effective treatment.

Need help finding Sotylize? Visit MedFinder to search for pharmacies with stock near you.