Sotalol general information

What is Sotalol used for?

Sotalol tablets 80mg are used to treat and prevent arrhythmia, which is abnormal or irregular heart beat, particularly supraventricular and ventricular arrhythmias.  Arrhythmias are due to irregular electrical activity of the heart and an arrhythmia refers to any change from the normal sequence of electrical impulses that controls the heart’s normal rhythm, causing abnormal heart rhythms.  They include atrial and ventricle arrhythmias and atrial fibrillation is the most common form of arrhythmia.  Supraventricular arrhythmia can cause shortness of breath, heart palpitations, chest tightness, and a very fast pulse, but is not usually life-threatening.  There are two types of ventricular arrhythmias and ventricular fibrillation is the most serious.  It is due to uncontrolled heartbeat causing the heart muscle to quiver instead of contracting so that it can no longer pump blood to the rest of the body and can cause heart attack or result in cardiac arrest.  Ventricular tachycardia is a rapid heartbeat due to loss of normal heart pacemaker function and this compromises the supply of blood and therefore, oxygen to the heart itself and the rest of the body.  This increases the workload on the heart and results in severe shortness of breath, dizziness, or fainting (syncope), but is not usually life-threatening.  Sotalol tablets 80mg help restore the heart’s normal rhythm and prevent irregular heartbeat.

How does Sotalol work?

Sotalol tablets 80mg contain sotalol, which is a non-selective beta-adrenergic receptor blocker without sympathomimetic activity or membrane stabilising activity.  Sotalol in Sotalol tablets 80mg binds to beta receptors that are found in vascular smooth muscle in blood vessel walls and several organs of the body, including the heart lungs and kidney, which blocks the action of chemicals called catecholamines, such as adrenaline (epinephrine) and noradrenaline (nor epinephrine), which are released by the adrenal glands in response to nerve stimulation during physical and mental stress.  Adrenaline binds to beta-receptors in the heart to stimulate increased heart rate and constriction (narrowing) of blood vessels.  These actions of adrenaline are reduced or inhibited by sotalol in Sotalol tablets 80mg, causing a decrease in heart rate and a reduction in the force of contraction of the heart; also widening of blood vessels, which increases blood flow and oxygen to the heart.  Sotalol in Sotalol tablets 80mg also has class III antiarrhythmic activity and interacts with the area of the heart muscle that controls the rate of the heartbeat known as the atrioventricular (AV) node.  The AV node sets the rhythm for contraction of the heart that forces blood from the atria or upper chambers to the ventricles or lower chambers of the heart and slows the transmission of current from the atria to the ventricles, to ensure that the atria fill up with blood fully before the next contraction.  Sotalol in Sotalol tablets 80mg works by reducing the speed of conduction and increasing the refractory period of the AV node, which lengthens the gap between one heart beat and the next and slows down the heart rate while restoring a regular pace.  The action potential, which drives the heart muscle contraction is based on myocardial (heart muscle) depolarisation and repolarisation, which is when sodium and potassium ions build up on one side of the membrane and are then released through special voltage-gated ion channels, causing a rapid rise and fall of membrane potential (the difference in electrical potential between the inside and the outside of the heart muscle cells).  Sotalol in Sotalol tablets 80mg is classified as a class III antiarrhythmic, because it works by blocking potassium channels in the myocardial cells, which delays or prolongs repolarisation, increases the duration of the action potential and thereby increases the refractory period.  This causes lengthening of the QTc interval on electrocardiographic recordings, which represents depolarisation and depolarisation of the ventricles This action of Sotalol in Sotalol tablets 80mg slows down a fast heartbeat and restores the heart’s normal rhythm.

What does Sotalol contain?

Sotalol tablets contains the active ingredient sotalol 80mg, a non-selective beta- blocker with class III antiarrhythmic activity, that is used to treat and prevent supraventricular and ventricular arrhythmia.  They also contain calcium hydrogen phosphate anhydrous, maize starch, povidone, sodium starch glycollate, purified talc and magnesium stearate.

Treating arrhythmia with Sotalol

Sotalol tablets 80mg contain sotalol, a non-selective beta-adrenergic receptor blocker with class III antiarrhythmic activity that is used to treat and prevent arrhythmia, which is abnormal or irregular heart beat, particularly supraventricular and ventricular arrhythmias.  Arrhythmia refers to any change from the normal sequence of electrical impulses that controls the heart’s normal rhythm, causing abnormal heart rhythms.  They include atrial and ventricle arrhythmias and atrial fibrillation is the most common form of arrhythmia.  Supraventricular arrhythmia can cause shortness of breath, heart palpitations, chest tightness, and a very fast pulse, but is not usually life-threatening.  There are two types of ventricular arrhythmias and ventricular fibrillation is the most serious.  It is due to uncontrolled heartbeat causing the heart muscle to quiver instead of contracting so that it can no longer pump blood to the rest of the body and can cause heart attack or result in cardiac arrest.  Ventricular tachycardia is a rapid heartbeat due to loss of normal heart pacemaker function and this compromises the supply of blood and therefore, oxygen to the heart itself and the rest of the body.  This increases the workload on the heart and results in severe shortness of breath, dizziness, or fainting (syncope), but is not usually life-threatening.  Sotalol in Sotalol tablets 80mg has two mechanisms of action to control arrhythmias.  As a beta blocker, it blocks the action of chemicals called catecholamines, such as adrenaline (epinephrine) and noradrenaline (nor epinephrine), which stimulate increased heart rate and constriction (narrowing) of blood vessels.  This action of sotalol causes a decrease in heart rate and a reduction in the force of contraction of the heart; also widening of blood vessels, which increases blood flow and oxygen to the heart.  As a class III antiarrhythmic, Sotalol in Sotalol tablets 80mg acts works by blocking potassium channels in the myocardial cells of the heart, which delays or prolongs repolarisation, increases the duration of the action potential, which drives the heartbeat and thereby increases the refractory period.  This slows down a fast heartbeat and restores the heart’s normal rhythm.

What are the side effects of Sotalol?

The most commonly reported side effects when taking Sotalol tablets 80mg include dyspnoea (shortness of breath), fatigue, dizziness, headache, fever, bradycardia (slow heartbeat), hypotension (low blood pressure), cold extremities, chest pain, palpitations, oedema, rash, mood changes, anxiety, depression, sexual dysfunction, visual and hearing disturbances, taste changes, paraesthesia (tingling).

When should Sotalol not be used?

You should not use Sotalol tablets 80mg if you:

• are allergic to sotalol or any ingredients in Sotalol
• are pregnant or are breastfeeding
• have kidney disease
• suffer from bronchospasm, including bronchial asthma or chronic obstructive airway disease; also allergic disorders (including allergic rhinitis) which may predispose to bronchospasm
• have right ventricular failure secondary to pulmonary hypertension
• have certain other heart conditions such as uncontrolled heart failure or an enlarged heart
• have sinus bradycardia (a very low heartbeat of less than 45-50 beats/minute)
• are in shock due to low blood volume (hypovolaemic) or inadequate pumping of the heart (cardiogenic)
• have congenital or acquired long QT syndromes.
• have AV block or sick sinus syndrome (unless pacemaker in situ)
• are taking medicines that interact with Sotalol, including calcium channel blockers like verapamil  or diltiazem for hypertension, angina or other heart conditions; insulin or other oral diabetes medications; anaesthetics like chloroform and cyclopropane; beta agonists such a salbutamol and terbutaline for bronchospasm and isoprenaline for bradycardia; catecholamine-depleting agents like reserpine the antipsychotic and guanethidine the antihypertensive; clonidine for hypertension; certain other medicines used to treat arrhythmias, such as quinidine, disopyramide, flecainide, mexiletine and amiodarone; potassium depleting diuretics; digoxin  for heart failure; alcohol; tricyclic antidepressants; the antihistamines terfenadine and astemizole for allergy

What medications interact with Sotalol?

Several medications interact with Sotalol tablets 80mg and should either not be taken while you are taking Sotalol or only after discussion and instruction from your doctor:

• Drugs that cause a serious reaction with Sotalol: calcium channel blockers like verapamil  or diltiazem for hypertension, angina or other heart conditions, anaesthetics like chloroform and cyclopropane, catecholamine-depleting agents like reserpine the antipsychotic and antihypertensive and guanethidine the antihypertensive, clonidine for hypertension, certain other medicines used to treat arrhythmias, such as quinidine, disopyramide, flecainide, mexiletine and amiodarone, potassium depleting diuretics, tricyclic antidepressants, the antihistamines terfenadine and astemizole for allergy, may prolong theQT interval
• Drugs that affect Sotalol: alcohol
• Drugs that are affected by Sotalol: insulin or other oral diabetes medications, digoxin  for heart failure

How should Sotalol be taken?

You should take your Sotalol tablets 80mg swallowed whole with a glass of water twice daily and 1-2 hours before meals.  The dose you take depends on you doctor’s recommendations and what you are being treated for and your dose may be increased gradually over a few days.  You should continue to take your Sotalol tablets 80mg regularly for as long as recommend by your doctor and may be for long term.

How long should you take Sotalol?

You should continue to take your Sotalol tablets 80mg regularly for as long as recommend by your doctor and may be for long term.

Missed dose of Sotalol

If you miss a dose of Sotalol tablets 80mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Sotalol be stored?

You should store your Sotalol below 25°C in a cool dry place.  

Urimax general information

What is Urimax used for?

How does Urimax work?

What does Urimax contain?

Treating urinary symptoms of benign prostatic hyperplasia (BPH) with Urimax

What are the side effects of Urimax?

When should Urimax not be used?

• are allergic to tamsulosin or any ingredients in Urimax capsules 0.2mg
• have liver or kidney disease
• have a history of orthostatic hypotension (dizziness, weakness)
• are taking medications that interact with Urimax, including: other alpha-blockers that relaxes smooth muscle, the antiinflammatory diclofenac, the anticoagulant warfarin, cimetidine for stomach ulcers

How should Urimax be taken?

How long should you take Urimax?

Missed dose of Urimax

How should Urimax be stored?

Female hormones

Throughout a woman’s fertile period the two hormones estrogen and progesterone (produced by the ovaries), work together to control the menstrual cycle. Estrogen stimulates ovulation and progesterone prepares the endometrium or lining of the uterus for implantation of a fertilised egg.  If pregnancy occurs progesterone continues to be produced by the placenta to maintain the pregnancy, if not levels of progesterone falls, which initiates menstruation.  The production of estrogen and progesterone is regulated by hormones produced by the pituitary gland - Follicle Stimulating Hormone (FSH) and Luteunising Hormone (LH), which in turn are under the control of Gonadotropin Releasing Hormones (GnRH) produced by the hypothalamus in the brain.   

Androgens are generally considered to be male hormones but they also have several functions in the female body, including puberty related changes like pubic hair growth, preventing bone loss, libido and for the production of oestrogen. 

Conditions caused by hormonal imbalance

• Lack of progesterone can result in menstrual disorders like, secondary amenorrhoea (menstrual periods that have stopped, are absent or irregular), dysmenorrhoea or painful periods, premenstrual syndrome and abnormal uterine bleeding, which occurs during the menstrual cycle instead of at the end.  Medication containing a form of progesterone can help treat these menstrual disorders.  Endometriosis, a condition where the endometrium grows outside the uterus and causes pain and bleeding can also be treated with progesterone.
• Overproduction of androgen or androgenisation causes hirsutism or production of unwanted hair, androgenic alopecia (hair loss) and polycystic ovary syndrome (PCOS), which is usually accompanied by acne and hirsutism and is related to insulin resistance and type-2 diabetes.  These conditions can be treated using anti-androgen drugs.

Treating symptoms of menopause 

As menopause approaches, the production of the female hormones estrogen and progesterone ceases, which brings to an end to the regular cycle of ovulation and menstruation.  A lack of estrogen causes the of symptoms including, hot flushes, night sweats, sleeplessness, vaginal dryness, headaches, mood swings, lack of concentration and loss of energy.  Estrogen also has several other actions in various metabolic processes including maintaining bone mass, which is why a lack of estrogen at menopause increases risk of osteoporosis.   

Hormone replacement therapy (HRT) is used to help relieve symptoms of menopause by replacing female hormones that the body has stopped making naturally.  HRT is generally in the form of an estrogen and can be delivered systemically as oral tablets or patches, or as topical creams for local vaginal symptoms like atrophic vaginitis.  Combination HRT includes a form of progesterone to reduce the risk of developing endometrial cancer due to estrogen alone.  

Other menopausal symptom relief medications available include clonidine, an alpha blocker and some dietary supplements that help reduce hot flushes.

Hormone based treatments for other conditions

This category also provides hormone based treatment for other women’s conditions, including:

• Some breast cancers and endometrial cancer, which are both estrogen-dependent tumours and can be treated with anti-estrogen drugs.
• Infertility due to lack of ovulation using an estrogen receptor modulator
• Osteoporosis or loss of bone mass is a common problem in postmenopausal women, which can be treated with medications that regulate bone turnover.