Drug interactions
Atenolol + Sotalol
Severity: Major
Atenolol and Sotalol: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both are beta-blockers and sotalol also has class III antiarrhythmic activity, so combining them is therapeutic duplication. This adds bradycardia, hypotension and AV block risk, and sotalol's QT prolongation raises proarrhythmic risk.
What this interaction means in plain words
Atenolol and Sotalol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atenolol belongs to Cardiovascular; Sotalol belongs to Cardiovascular.
Why it happens
Duplicate beta-adrenergic blockade with additive negative chronotropic and inotropic effects, plus sotalol potassium-channel blockade.
What to do
Avoid combining two systemic beta-blockers; choose a single agent suited to the indication. If the combination occurs, stop one agent and monitor heart rate, blood pressure and QTc.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Atenolol
- Amifostine + Atenolol Major
- Amiodarone + Atenolol Major
- Atenolol + Atenolol-chlorthalidone Major
- Atenolol + Betaxolol Major
- Atenolol + Bisoprolol Major
- Atenolol + Carvedilol Major
Other interactions of Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Atenolol with Sotalol?
MediHelp rates the interaction as major. Atenolol and Sotalol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both are beta-blockers and sotalol also has class III antiarrhythmic activity, so combining them is therapeutic duplication. This adds bradycardia, hypotension and AV block risk, and sotalol's QT prolongation raises proarrhythmic risk.
How serious is the interaction between Atenolol and Sotalol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combining two systemic beta-blockers; choose a single agent suited to the indication. If the combination occurs, stop one agent and monitor heart rate, blood pressure and QTc.
What other medicines interact with Atenolol?
MediHelp also lists interactions of Atenolol with, for example, Amifostine, Amiodarone, Atenolol-chlorthalidone. The full list is on the Atenolol page.
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