Q: Sotalol is contra-indicated or should be used with extreme caution as it may cause sudden cardiac death in? 

 A) Liver failure
B) Renal failure
C) Ejection fraction less than 20%
D) In patients with mechanical valves
E) along with metformin


Answer: B


Risk of sotalol in renal failure is known since more than 40 years. It should be used in renal failure only by experienced hands!


References: 

1. Sundquist HK, Anttila M, Forsström J, Kasanen A. - Serum levels and half-life of sotalol in chronic renal failure. - Ann Clin Res. 1975 Dec;7(6):442-6. 

2. Bathen J, Madsen S. - Sotalol--atrial fibrillation, reduced renal function and sudden death - Tidsskr Nor Laegeforen. 1998 Oct 30;118(26):4086-7.