Bisoprolol sotalol and flecanide

[Deja]

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Patient is taking bisoprolol and flecanide now just being prescribed sotalol... what do you guys think

 

[awval999]

Patient is taking bisoprolol and flecanide now just being prescribed sotalol... what do you guys think

Well the bisoprolol is a beta-blocker being used for BP and/or HR.

The flecainide is a class 1C anti-arrhythmic (Na+).

The sotalol is a class III anti-arrhythmic (K+). While it is a beta-blocker is isn't used for BP/HR here and isn't duplicating the bisoprolol.

I would call and make sure that the sotalol isn't replacing the flecainide.

 

[Deja]

Well the bisoprolol is a beta-blocker being used for BP and/or HR.

The flecainide is a class 1C anti-arrhythmic (Na+).

The sotalol is a class III anti-arrhythmic (K+). While it is a beta-blocker is isn't used for BP/HR here and isn't duplicating the bisoprolol.

I would call and make sure that the sotalol isn't replacing the flecainide.

Yeah I was mainly wondering about sotalol with flecanide, doesn't seem like a whole lot benefits with flecanide... it's a Saturday so thought I'd post it up here

 

[RxPreceptor]

Cardiologists in my area have been ok w/ sotalol or propafenone (some BB) + beta-1 selective antagonist; confirm w/ MD as always

 

[BidingMyTime]

It seems like an odd combination & 1 I don't think I've ever personally seen, my question would be, is it being prescribed by 1 doctor (preferably a cardiologist) or is this being prescribed by a family doctor or NP who really should be referring the patient to a specialist?

 

[Deja]

It seems like an odd combination & 1 I don't think I've ever personally seen, my question would be, is it being prescribed by 1 doctor (preferably a cardiologist) or is this being prescribed by a family doctor or NP who really should be referring the patient to a specialist?

It was by the cardiologist, same doctor, Patient is stopping the flecainide like I suspected 🙂 They really should make that clear on the script also

 

[Zynx]

I really appreciate UpToDate:

"Although some have suggested that combination antiarrhythmic drug therapy (eg, a class IC agent with sotalol or amiodarone, often in lower doses) may be an alternative, there are limited data to support such an approach and the patient may be exposed to a greater risk of proarrhythmia and other side effects.

As a result, combination antiarrhythmic drug therapy is not recommended. Such patients can be treated with a rate control strategy or referred for nonpharmacologic therapy to prevent recurrent AF including surgery (such as the maze operation) or catheter ablation (such as pulmonary vein isolation).