Drug interactions
Metaproterenol + Sotalol
Severity: Major
Metaproterenol 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
Sotalol blocks beta-2 receptors and can counteract the bronchodilation from metaproterenol, potentially provoking bronchospasm. Beta-agonist induced hypokalemia and tachycardia can also increase the risk of arrhythmia with sotalol.
What this interaction means in plain words
Metaproterenol 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.
Why it happens
Pharmacodynamic antagonism at beta-2 receptors plus beta-agonist induced hypokalemia that adds to the QT risk.
What to do
Avoid the combination in patients with asthma or COPD and choose another antiarrhythmic. If it cannot be avoided, monitor respiratory function, potassium and ECG.
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
Frequently asked questions
Can I take Metaproterenol with Sotalol?
MediHelp rates the interaction as major. Metaproterenol 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. Sotalol blocks beta-2 receptors and can counteract the bronchodilation from metaproterenol, potentially provoking bronchospasm. Beta-agonist induced hypokalemia and tachycardia can also increase the risk of arrhythmia with sotalol.
How serious is the interaction between Metaproterenol 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 the combination in patients with asthma or COPD and choose another antiarrhythmic. If it cannot be avoided, monitor respiratory function, potassium and ECG.
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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