Drug interactions
Furosemide + Sotalol
Severity: Major
Furosemide and Sotalol: major interaction.
Last updated Sources: UK SmPC
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
Furosemide-induced hypokalemia and hypomagnesemia prolong the QT interval vulnerability of sotalol, raising the risk of torsades de pointes. This is clinically important because sotalol itself prolongs repolarization in a dose-dependent manner.
What this interaction means in plain words
Furosemide 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.
Furosemide belongs to Cardiovascular; Sotalol belongs to Cardiovascular.
Why it happens
Loop diuretic electrolyte depletion (potassium, magnesium) potentiates sotalol-mediated QT prolongation and proarrhythmia.
What to do
Check and correct potassium and magnesium before and during sotalol therapy, keeping potassium in the normal range. Monitor ECG QT interval and renal function, and reduce the sotalol dose if QT lengthens.
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 Furosemide
- Amifostine + Furosemide Major
- Amikacin + Furosemide Major
- Carbenoxolone + Furosemide Major
- Cephaloridine + Furosemide Major
- Cisplatin + Furosemide Major
- Digoxin + Furosemide 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 Furosemide with Sotalol?
MediHelp rates the interaction as major. Furosemide 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. Furosemide-induced hypokalemia and hypomagnesemia prolong the QT interval vulnerability of sotalol, raising the risk of torsades de pointes. This is clinically important because sotalol itself prolongs repolarization in a dose-dependent manner.
How serious is the interaction between Furosemide 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: Check and correct potassium and magnesium before and during sotalol therapy, keeping potassium in the normal range. Monitor ECG QT interval and renal function, and reduce the sotalol dose if QT lengthens.
What other medicines interact with Furosemide?
MediHelp also lists interactions of Furosemide with, for example, Amifostine, Amikacin, Carbenoxolone. The full list is on the Furosemide page.
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