Drug interactions
Cocaine + Sotalol
Severity: Moderate
Cocaine and Sotalol: moderate interaction.
Last updated
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
Beta-blockade in the presence of cocaine can leave alpha-adrenergic vasoconstriction unopposed, raising blood pressure and potentially causing coronary vasospasm or angina. Systemic exposure from topical cocaine is limited but can be meaningful on mucosal surfaces.
What this interaction means in plain words
Cocaine and Sotalol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cocaine belongs to Central Nervous System; Sotalol belongs to Cardiovascular.
Why it happens
Non-selective beta-blockade leaves cocaine-induced alpha-mediated vasoconstriction unopposed.
What to do
Avoid or minimize cocaine dosing in patients on sotalol and monitor blood pressure, heart rate and chest pain after use. Choose an alternative topical anesthetic if possible.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Other interactions of Cocaine
- Cocaine + Isocarboxazid Contraindicated
- Cocaine + Phenelzine Contraindicated
- Cocaine + Procarbazine Contraindicated
- Amitriptyline + Cocaine Major
- Bisoprolol + Cocaine Major
- Citalopram + Cocaine Major
Frequently asked questions
Can I take Cocaine with Sotalol?
MediHelp rates the interaction as moderate. Cocaine and Sotalol can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Beta-blockade in the presence of cocaine can leave alpha-adrenergic vasoconstriction unopposed, raising blood pressure and potentially causing coronary vasospasm or angina. Systemic exposure from topical cocaine is limited but can be meaningful on mucosal surfaces.
How serious is the interaction between Cocaine and Sotalol?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid or minimize cocaine dosing in patients on sotalol and monitor blood pressure, heart rate and chest pain after use. Choose an alternative topical anesthetic if possible.
What other medicines interact with Sotalol?
MediHelp also lists interactions of Sotalol with, for example, Arsenic trioxide, Artemether / lumefantrine, Disopyramide. The full list is on the Sotalol page.
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