Drug interactions
Neostigmine + Sotalol
Severity: Moderate
Neostigmine 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
Neostigmine enhances vagal tone and slows heart rate, which adds to the bradycardic effect of sotalol. Bradycardia or AV block may result, particularly when neostigmine is given for reversal of neuromuscular blockade.
What this interaction means in plain words
Neostigmine 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.
Neostigmine belongs to Central Nervous System; Sotalol belongs to Cardiovascular.
Why it happens
Additive bradycardia from cholinesterase inhibition (increased vagal tone) and beta-blockade.
What to do
Monitor ECG and heart rate when giving neostigmine, and have an anticholinergic such as glycopyrrolate or atropine available.
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 Neostigmine
Frequently asked questions
Can I take Neostigmine with Sotalol?
MediHelp rates the interaction as moderate. Neostigmine 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. Neostigmine enhances vagal tone and slows heart rate, which adds to the bradycardic effect of sotalol. Bradycardia or AV block may result, particularly when neostigmine is given for reversal of neuromuscular blockade.
How serious is the interaction between Neostigmine 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: Monitor ECG and heart rate when giving neostigmine, and have an anticholinergic such as glycopyrrolate or atropine available.
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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