Andrew D. Blair, Ph.D., Ellen D. Burgess, M.D., Barbara M. Maxwell, B.A., and. Ralph E. Cutler, M.D. Seattle, Wash. The Urzii~et-sit!: of Washington School ...
Sotalol kinetics in renal insufficiency Kinc,tics ~f'sotalol,a beta adrenoceptor blocker, was studied in 20 patients ~vithvarying renal ,fitnction. In ~ubjects\t'ith creatinine clearance (CI,,) 2 39 m l l m i n / m ~sotalol plasma clearatzc~~ (7 + SD) M ~ 71S & 31 tnllminlm', elirnirzation half-/@ (tYz) tvas 8.1 ? 3.4 hr, and renal c,leurance N U S 46 2 26 ml/rnin/tn2. In patients tt3ith tnorierute renal impairment (Cl,, = 8 to 38 7 rnl/~nin/tn~) elirnirzation t'/z rose to 24.2 r 7.5 hr, and plasma clearance,fell to 24 rnl/min/rn2.In patients recei~~irzg dialysis, c~litninationtlh rose to 33.9 + 27.1 hr. Elirninution 1% during ketnodiulysis itus 5.8 t 2.1 hr and w i s associated with a 56.7 r 21 C?r reduction in pliis~nalevels.
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Andrew D. Blair, Ph.D., Ellen D. Burgess, M.D., Barbara M. Maxwell, B.A., and Ralph E. Cutler, M.D. Seattle, Wash. of Washington School ($Medic,ine, Harboriien Meilical Center The Urzii~et-sit!:
Sotalol, 4'-(2-isopropylamino-1-hydroxy-ethy1)methane sulfonanilide monohydrochloride, a beta adrenoceptor antagonist, lacks membranestabilizing or local anesthetic action and intrinsic sympathomimetic activity.j The efficacy of sotalol in the treatment of supraventricular tachycardias is of the same order as that of propranolol, practolol, oxprenolol, and acebuto101.~3 Sotalol has been effective in the treatment of mild to severe hypertension with only a once or twice daily dose.'" l 9 The frequency of angina attacks has decreased with a minimum of side effects with sotalol therapy.3. ti Unlike other beta adrenoreceptor antagonists but nadolol, sotalol is primarily excreted unchanged in the urine and therefore would be expected to have a longer elimination half-life
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Supported in part by grants from the General Clinical Research Centers Program (RR-133) of the Division of Research Resources, National Institutes of Health; Mead Johnson Laboratories; and the Clinfo Computer System, GCRC (RR-37). Received for publication July 7, 1980. Accepted for publication Dec. 17, 1980. Reprint requests to: Ralph E. Cutler, M.D., Harborview Medical Center, 325 Ninth Ave., Seattle, WA 98104.
(tM) in patients with renal insufficiency than the others.". ' O . 2 W u r purpose was to study sotalol kinetics in normal subjects and in patients with renal insufficiency and renal failure. Methods
Subjects were divided into three groups according to creatinine clearance (Cl,,): group 1 , Cl,,
