Drug interactions
Sotalol + Tolvaptan
Severity: Moderate
Sotalol and Tolvaptan: 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
Tolvaptan can cause rapid shifts in serum sodium and may alter potassium, and electrolyte disturbances increase the proarrhythmic risk of sotalol. Sotalol requires normal potassium and magnesium to limit torsades de pointes. There is no strong direct pharmacological interaction between the two.
What this interaction means in plain words
Sotalol and Tolvaptan 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.
Sotalol belongs to Cardiovascular; Tolvaptan belongs to Endocrine.
Why it happens
Indirect effect: tolvaptan-induced electrolyte changes may heighten sotalol's QT-related proarrhythmic risk.
What to do
Monitor serum sodium, potassium and ECG during tolvaptan initiation and dose changes. Correct electrolyte abnormalities promptly.
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 Tolvaptan
- Atazanavir + Tolvaptan Contraindicated
- Ceritinib + Tolvaptan Contraindicated
- Cobicistat + Tolvaptan Contraindicated
- Conivaptan + Tolvaptan Contraindicated
- Darunavir + Tolvaptan Contraindicated
- Idelalisib + Tolvaptan Contraindicated
Frequently asked questions
Can I take Sotalol with Tolvaptan?
MediHelp rates the interaction as moderate. Sotalol and Tolvaptan 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. Tolvaptan can cause rapid shifts in serum sodium and may alter potassium, and electrolyte disturbances increase the proarrhythmic risk of sotalol. Sotalol requires normal potassium and magnesium to limit torsades de pointes. There is no strong direct pharmacological interaction between the two.
How serious is the interaction between Sotalol and Tolvaptan?
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 serum sodium, potassium and ECG during tolvaptan initiation and dose changes. Correct electrolyte abnormalities promptly.
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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