Drug interactions
Propranolol + Sotalol
Severity: Major
Propranolol 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 is itself a nonselective beta blocker with class III antiarrhythmic activity, so adding propranolol duplicates beta blockade. This raises the risk of severe bradycardia, hypotension and AV block, with the QT-related proarrhythmic risk of sotalol remaining.
What this interaction means in plain words
Propranolol 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.
Propranolol belongs to Cardiovascular; Sotalol belongs to Cardiovascular.
Why it happens
Additive pharmacodynamic nonselective beta-adrenergic blockade.
What to do
Avoid the combination and use only one beta-blocking agent. Monitor ECG and heart rate if a switch between them is being made.
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 Propranolol
- Propranolol + Thioridazine Contraindicated
- Acebutolol + Propranolol Major
- Adrenaline-articaine + Propranolol Major
- Amifostine + Propranolol Major
- Amiodarone + Propranolol Major
- Arformoterol + Propranolol 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 Propranolol with Sotalol?
MediHelp rates the interaction as major. Propranolol 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 is itself a nonselective beta blocker with class III antiarrhythmic activity, so adding propranolol duplicates beta blockade. This raises the risk of severe bradycardia, hypotension and AV block, with the QT-related proarrhythmic risk of sotalol remaining.
How serious is the interaction between Propranolol 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 and use only one beta-blocking agent. Monitor ECG and heart rate if a switch between them is being made.
What other medicines interact with Propranolol?
MediHelp also lists interactions of Propranolol with, for example, Thioridazine, Acebutolol, Adrenaline-articaine. The full list is on the Propranolol page.
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