Drug interactions
Procainamide + Sotalol
Severity: Contraindicated
Procainamide and Sotalol: contraindicated 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 agents prolong repolarization, and combining class III and class IA antiarrhythmics greatly increases the risk of torsades de pointes. Procainamide also has proarrhythmic effects and its active metabolite NAPA has class III activity, accumulating in renal impairment.
What this interaction means in plain words
Procainamide and Sotalol are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Additive IKr blockade (procainamide and NAPA) with sotalol causing excessive QT prolongation.
What to do
Avoid concurrent use; choose a single antiarrhythmic strategy. If switching, allow adequate washout of the first drug with ECG monitoring.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Procainamide and Sotalol, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Procainamide with Sotalol?
MediHelp rates the interaction as contraindicated. Procainamide and Sotalol are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Both agents prolong repolarization, and combining class III and class IA antiarrhythmics greatly increases the risk of torsades de pointes. Procainamide also has proarrhythmic effects and its active metabolite NAPA has class III activity, accumulating in renal impairment.
How serious is the interaction between Procainamide and Sotalol?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use; choose a single antiarrhythmic strategy. If switching, allow adequate washout of the first drug with ECG monitoring.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
