Enhanced elimination

Sotalol and atenolol are renally eliminated. Haemodialysis improves elimination of sotalol and atenolol when there is evidence of kidney impairment.

Consider haemodialysis in patients with severe sotalol poisoning who have kidney impairment (estimated glomerular filtration rate [eGFR] less than 45 mL/min), if refractory bradycardia, refractory hypotension, or recurrent torsades de pointes is presentBouchard 2021. If required, intermittent haemodialysis is the preferred modality.

Severe atenolol poisoning is rare and haemodialysis is unlikely to be required.

If considering haemodialysis for sotalol or atenolol poisoning, seek advice from a clinical toxicologist.

For more information on haemodialysis, see Enhanced elimination of poisons.