Medications that control or prevent abnormal heart rhythms ("Anti-Arrhythmics")

Name Sotalol
Class Anti-arrhythmic
Indications Management of abnormal heart rhythms (arrhythmias)
Mechanism of Action Makes the electrical activity of the cardiac cells last longer, preventing other premature impulses from triggering an abnormal heart rhythm 
Dosing dosing depends on patient's age, kidney function, heart rate and QT interval on ECG. Initial dose is 30mg/m2/dose three times daily. Maximum dose is 60mg/m2/dose
How it's Given IV or by mouth
Frequency three times daily
Time of Onset 1-2hours (IV)
Side Effects low heart rate, chest pain, palpitations, lightheadedness, dizziness, nausea, headache, shortness of breath, fatigue

 

Name Flecainide
Class Anti-arrhythmic
Indications Management of abnormal heart rhythms (arrhythmias)
Mechanism of Action Prolongs the time it takes for cardiac cells to "re-set" their electrical activity; makes cardiac cells take longer to become excited or activiated
Dosing Dosing is dependent upon the specific indication: Initial dosing - either 50mg/m2/day (if less than 6months old) or 100mg/m2/day (if older than 6 months) given either two or three times daily. Maximum dose is 200mg/m2/day
How it's Given By mouth
Frequency Every 8 or every 12 hours
Time of Onset 2-3 hours
Side Effects nausea, headache, dizziness, blurred vision, nervousness, shortness of breath, fatigue

 

Name Amiodarone
Class Anti-arrhythmic
Indications Treatment of abnormal heart rhythms (arrhythmias), particularly those arising from the bottom chambers of the heart (ventricles)
Mechanism of Action Makes the electrical activity of the cardiac cells last longer, preventing other premature impulses from triggering an abnormal heart rhythm; Prolongs the time it takes for cardiac cells to "re-set" their electrical activity 
Dosing By mouth: 5 to 15mg/kg/day, divided in two daily doses. IV: 5mg/kg/dose load, 0.005-0.01mg/kg/min maintenance
How it's Given IV or by mouth
Frequency Every 12 hours (if by mouth)
Time of Onset By mouth: 4 to 6 hours
Side Effects low heart rate, low blood pressure, photosensitivity, thyroid gland dysfunction, constipation, loss of appetite, nausea, vomiting, liver inflammation, dizziness, neuropathy, abnormal motor coordination, visual disturbances

 

Name Propafenone
Class Anti-arrhythmic
Indications Management of abnormal heart rhythms (arrhythmias)
Mechanism of Action Makes cardiac cells take longer to become excited or activiated Prolongs the time it takes for cardiac cells to "re-set" their electrical activity 
Dosing 600mg/m2/day
How it's Given By mouth
Frequency  
Time of Onset 2-3.5 hours
Side Effects chest pain, palpitations, constipation, nausea, altered taste, vomiting, dizziness, shortness of breath, fatigue

 

Name Atenolol (Tenormin)
Class Beta blocker 
Indications high blood pressure (hypertension), prevention of heart rhythm abnormalities (arrhythmias)
Mechanism of Action Blocks the activity of "beta-adrenergic" receptors in the heart, allowing the heart muscle to relax (contract less forcefully), resulting in a drop in blood pressure; it also slows down the conduction of electrical signals of the heart, resulting in a slower heart rate
Dosing Prevention of Arrhythmias: 0.3-1.4mg/kg/dose once daily; Hypertension: 0.5-1 mg/kg/day in 1 or 2 divided doses
How it's Given IV or by mouth 
Frequency every 12 or 24 hours, depending on the indication
Time of Onset initial response in 3 hours
Side Effects slow heart rate (bradycardia), cold extremities, low blood pressure (hypotension), dizziness, depression, fatigue

 

Name Propranolol (Inderal)
Class Beta blocker, non-selective
Indications high blood pressure (hypertension); prevention/management of arrhythmias
Mechanism of Action blocks the activity of "beta-adrenergic" receptors found in the heart and smooth muscle lining the blood vessels of the kidney and airways of the lung; results in decreases in heart rate, blood pressure, and contractile force of the heart; also results in dilation of the airways in the lungs, resulting in more open airways.
Dosing Arrhythmias: initial dosing, 0.5-1 mg/kg/d divided in 3 to 4 daily doses. Your doctor will titrate the dose every 3 to 4 days until desired effect is attained, maximum dose of 4mg/kg/day. Hypertension: 0.5-1mg/kg/day divided every 6 to 12 hours. Your doctor will titrate every 3 to 7 days until desired effect is attained, maximum dose of 6mg/kg/day.
How it's Given IV or by mouth
Frequency depends on indication, see dosing above
Time of Onset 1-2 hours if given by mouth, 2-10minutes if given IV
Side Effects rash, itchiness, dizziness, fatigue

 

Name Nadolol (Corgard)
Class Beta-blocker, non-selective
Indications Prevention/management of arrhythmias
Mechanism of Action blocks the activity of "beta-adrenergic" receptors found in the heart and smooth muscle lining the blood vessels of the kidney and airways of the lung; results in decreases in heart rate, blood pressure, and contractile force of the heart; also results in dilation of the airways in the lungs, resulting in more open airways.
Dosing 0.5 to 1mg/kg/dose, once daily. Titrate by 1mg/kg/day until desired effect attained, maximum dose 2.5mg/kg/day
How it's Given by mouth
Frequency once daily
Time of Onset 3-4 hours
Side Effects slow heart rate (bradycardia), dizziness, fatigue

Quick Links

Contact Us

Children's Heart Institute

P. O Box 10066 McLean, VA 22102

Central Registration (patient appointments):

phone - 703-481-5801

Billing Inquiries:

phone - 571-612-2600 /  fax - 571-266-4096