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How Can I Taper Off Sotalol Slowly Without Any Side Effects?
Question: I've been on sotalol for 2 years after being put on it after an afib event. 80 mg. 2 years normal ekg's and bloodwork, ultrasound normal -- no more syptoms but --feeling reported side effects of medication -- tiredness,sleepyness, jittery, wake up after terrible nighmares .. all reported with tihs med. Can i slowly taper off and how?
Brief Answer:
Can be stopped if No AF and ECHO normal.
Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney.
I understand your concern.
See, AF can be of many types and can be due to many reasons.
Important here is to find out the reason and treat it.
Many times the AF is transient and it goes away. So, medications like Sotalol are not required if your rhythm and Pulse rate are within normal limits.
If Pulse rate is high or there are rhythm abnormalities, one requires to take these medicines.
I would advise you to get an ECHOCARDIOGRAPHY done. If ECHO is normal , and there are no clots and AF, the medicine can be stopped.
However , I would attribute your symptoms of Tiredness, nightmares , jitteriness to Sleep Apnea.
Most commonly sleep apnea causes such problems.
I would advise you to go for Sleep Study and if required you can go for BIPAP.
Weight reduction is must in your case.
I am hopeful, I am able to help you with your query.
If you have any further query please ask me.
Stay Healthy.
Can be stopped if No AF and ECHO normal.
Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney.
I understand your concern.
See, AF can be of many types and can be due to many reasons.
Important here is to find out the reason and treat it.
Many times the AF is transient and it goes away. So, medications like Sotalol are not required if your rhythm and Pulse rate are within normal limits.
If Pulse rate is high or there are rhythm abnormalities, one requires to take these medicines.
I would advise you to get an ECHOCARDIOGRAPHY done. If ECHO is normal , and there are no clots and AF, the medicine can be stopped.
However , I would attribute your symptoms of Tiredness, nightmares , jitteriness to Sleep Apnea.
Most commonly sleep apnea causes such problems.
I would advise you to go for Sleep Study and if required you can go for BIPAP.
Weight reduction is must in your case.
I am hopeful, I am able to help you with your query.
If you have any further query please ask me.
Stay Healthy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you.The recent echo from last month was normal. There was nothing unusual found over the 2 years - normal ekg and blood testing. I do understnad that apnea could contribute to these symptoms, although i read lethargy and nightmares are reported side effects of the drug. I am on a diet currently to lose weight that should improve the possible sleep issue. Can i stop the drug suddenly or should i taper off?
Brief Answer:
You need to consult your cardiologist.
Detailed Answer:
Dear Friend.
It's good if your ECHO and ECG are normal. But concern is the Pulse rate. Your rhythm is regular but rate needs to be controlled. That might be the reason that your doctor has continued on Sotalol.
You need to discuss with him the reason.
If that's the Pulse rate only, you can ask him to continue you with some other medications like Metoprolol instead of Sotalol which can help in controlling the Pulse rate with minimal side effects.
If you have any further query please ask me.
Stay Heat.
You need to consult your cardiologist.
Detailed Answer:
Dear Friend.
It's good if your ECHO and ECG are normal. But concern is the Pulse rate. Your rhythm is regular but rate needs to be controlled. That might be the reason that your doctor has continued on Sotalol.
You need to discuss with him the reason.
If that's the Pulse rate only, you can ask him to continue you with some other medications like Metoprolol instead of Sotalol which can help in controlling the Pulse rate with minimal side effects.
If you have any further query please ask me.
Stay Heat.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I see. Yes i now know what to ask. The doctor was supposed to get back with me after the recent echo and bloodwork and ekg, which were reported to me as normal. Thank you for clarification. If i have other questions will you be available today (and this week?)
Brief Answer:
I am always available for you
Detailed Answer:
Dear Friend.
Yes, i am always available for you.
You can ask me any questions/queries you have.
If you have no further queries, you may please close the discussion and rate it.
Stay Healthy.
I am always available for you
Detailed Answer:
Dear Friend.
Yes, i am always available for you.
You can ask me any questions/queries you have.
If you have no further queries, you may please close the discussion and rate it.
Stay Healthy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Spoke with doctor again today. He asked if I want to go off the sotalol, I said yes due to perceived side affects --so he is going to prescribe Flecainide and a calcium channel blocker. What do you think? Do I need both? I read where you can take these on an as needed basis and not continuously.
Brief Answer:
Calcium channel Blocker should be taken.
Detailed Answer:
Welcome again.
I suppose he wants to keep you on both rhythm and rate control. Probably he has been observing some problems.
I suppose that Calcium channel blockers like Diltiazem can be taken taken for rate control so that your pulse rate doesn't get disturbed.
You can meet him and ask him the need of Flecainide as your AF is now rerverted.
You can ask him and then discuss with me. Since he knows your cases since long , there might be some aspect that you might not be knowing for which he wants you to be on medicines.
If you have any further query please ask me.
Stay Healthy.
Calcium channel Blocker should be taken.
Detailed Answer:
Welcome again.
I suppose he wants to keep you on both rhythm and rate control. Probably he has been observing some problems.
I suppose that Calcium channel blockers like Diltiazem can be taken taken for rate control so that your pulse rate doesn't get disturbed.
You can meet him and ask him the need of Flecainide as your AF is now rerverted.
You can ask him and then discuss with me. Since he knows your cases since long , there might be some aspect that you might not be knowing for which he wants you to be on medicines.
If you have any further query please ask me.
Stay Healthy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
i am reading on web about the downside of flecainide - and am concerned about starting it -- my intention is to wean off the sotalol based on my negative results of testing -- and not embark on another drug with possible rosk
Brief Answer:
Detail Follows.
Detailed Answer:
Dear Friend.
If your rhythm is normal and you had transient AF, I also don't advise Flecainide use. I suppose, Metoprolol or Dilitiazem alone would be enough for you for rate control.
If you were my patient, with no other risk factor with no history of recurrent AF with only one AF that too transient and reverted back completely with normal ECHO and ECG, I would have put you on simple Diltiazem.
So, discussing with your cardiologist why he wants you to be on Flecainide is a nice idea.
Infact till now also, you have been on no drug like Flecainide properties.
You have been on rate control with Sotalol. So, that can be achieved with Diltiazem very well.
I hope it helps.
If you have any further query please ask me.
Stay Healthy.
Detail Follows.
Detailed Answer:
Dear Friend.
If your rhythm is normal and you had transient AF, I also don't advise Flecainide use. I suppose, Metoprolol or Dilitiazem alone would be enough for you for rate control.
If you were my patient, with no other risk factor with no history of recurrent AF with only one AF that too transient and reverted back completely with normal ECHO and ECG, I would have put you on simple Diltiazem.
So, discussing with your cardiologist why he wants you to be on Flecainide is a nice idea.
Infact till now also, you have been on no drug like Flecainide properties.
You have been on rate control with Sotalol. So, that can be achieved with Diltiazem very well.
I hope it helps.
If you have any further query please ask me.
Stay Healthy.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Question: I've been reasonably healthy until I had afib following a gallbladder operation in 2012. It was treated in the hopsital then i was released. When i left the hospital i was not on any medication and so i'd consider the afib probably unresolved. When i had symptoms many months later, i was put on the sotalol to control it. Is it fair to say that it was only one extended afib incident? I'm thinking that i really didn't have a REPEAT afib event but just one extended untreated event. I ask because the doctors make a distinction between a lone event and it coming back. lone events are treated differnetly than repeat... please advise.
Brief Answer:
Not lone AF in my opinion.
Detailed Answer:
Dear Friend.
Lone AF we term when a person gets AF without any apparent preexisting cardiac or lung precipitating cause.
You have Obstructive Sleep Apnea that can precipitate AF, so I won't classify you as a case of Lone AF
Since you had a single event of transient AF, you just require rate control from my point of view.
Rate control can be well achieved with Beta Blockers or Calcium channel blockers. As discussed previously, ask your doctor for Diltiazem or Metoprolol.
I don't feel the need of any other drug.
If you have any further query please ask me.
Not lone AF in my opinion.
Detailed Answer:
Dear Friend.
Lone AF we term when a person gets AF without any apparent preexisting cardiac or lung precipitating cause.
You have Obstructive Sleep Apnea that can precipitate AF, so I won't classify you as a case of Lone AF
Since you had a single event of transient AF, you just require rate control from my point of view.
Rate control can be well achieved with Beta Blockers or Calcium channel blockers. As discussed previously, ask your doctor for Diltiazem or Metoprolol.
I don't feel the need of any other drug.
If you have any further query please ask me.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Prasad
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