Drug interactions
Flecainide + Sotalol
Severity: Major
Flecainide 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 antiarrhythmics with proarrhythmic potential. Flecainide is negatively inotropic and slows conduction, and sotalol is a beta-blocker that prolongs QT, so combined use risks bradycardia, heart block, heart failure and ventricular arrhythmias.
What this interaction means in plain words
Flecainide 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.
Flecainide belongs to Cardiovascular; Sotalol belongs to Cardiovascular.
Why it happens
Additive effects on cardiac conduction and repolarisation combined with additive negative inotropy.
What to do
Avoid unless directed by a cardiologist; if used, monitor ECG (QRS and QTc), heart rate and left ventricular function.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Other interactions of Flecainide
- Flecainide + Nirmatrelvir Contraindicated
- Flecainide + Nirmatrelvir / ritonavir Contraindicated
- Flecainide + Pimozide Contraindicated
- Flecainide + Ritonavir Contraindicated
- Flecainide + Thioridazine Contraindicated
- Flecainide + Tipranavir Contraindicated
Frequently asked questions
Can I take Flecainide with Sotalol?
MediHelp rates the interaction as major. Flecainide 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 antiarrhythmics with proarrhythmic potential. Flecainide is negatively inotropic and slows conduction, and sotalol is a beta-blocker that prolongs QT, so combined use risks bradycardia, heart block, heart failure and ventricular arrhythmias.
How serious is the interaction between Flecainide 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 unless directed by a cardiologist; if used, monitor ECG (QRS and QTc), heart rate and left ventricular function.
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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