Two individuals taking sotalol developed a side effect of the drug (a heart arrhythmia known as torsades de pointes) which was effectively treated with intravenous magnesium.1, 2 Additional research is needed to determine whether people taking sotalol might be able to prevent this side effect by taking supplemental magnesium.
One controlled study showed that taking sotalol with a calcium gluconate solution dramatically reduces the absorption of the drug.3 Consequently, people who take a calcium supplement should take sotalol an hour before or two hours after the calcium.
People with prolonged diarrhea and vomiting, as well as those taking potassium-depleting diuretics, might develop low blood potassium levels. Individuals with low blood potassium levels who take sotalol have an increased risk of developing a serious heart arrhythmia and fainting. Therefore, people taking sotalol should have their blood potassium levels checked regularly and may need to supplement with potassium, especially when taking potassium-depleting diuretics.
Some beta-adrenergic blockers (called “nonselective” beta blockers) decrease the uptake of potassium from the blood into the cells,5 leading to excess potassium in the blood, a potentially dangerous condition known as hyperkalemia.6 People taking beta-blockers should therefore avoid taking potassium supplements, or eating large quantities of fruit (e.g., bananas), unless directed to do so by their doctor.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
1. Sasse M, Paul T, Bergmann P, Kallfelz HC. Sotalol associated torsades de pointes tachycardia in a 15-month-old child: successful therapy with magnesium aspartate. Pacing Clin Electrophysiol 1998;21:1164–6.
2. Arstall MA, Hii JT, Lehman RG, Horowitz JD. Sotalol-induced torsade de pointes: management with magnesium infusion. Postgrad Med J 1992;68:289–90.
3. Kahela P, Anttila M, Tikkanen R, Sundquist H. Effect of food, food constituents and fluid volume on the bioavailability of sotalol. Acta Pharmacol Toxicol (Copenh) 1979;44:7–12.
4. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996, 213–4.
5. Rosa RM, Silva P, Young JB, et al. Adrenergic modulation of extrarenal potassium disposal. N Engl J Med 1980;302:431–4.
6. Lundborg P. The effect of adrenergic blockade on potassium concentrations in different conditions. Acta Med Scand Suppl 1983;672:121–6 [review].
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The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2014.
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