ArticlePrenatal diagnosis2026
Sotalol Dose Optimization for Fetal Tachycardia: A Pregnancy Physiologically Based Pharmacokinetic Model Study.
Article in Prenatal diagnosis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo establish an optimized sotalol dosing strategy for fetal tachycardia using a pregnancy physiologically based pharmacokinetic (PBPK) model.
methodA verified PBPK model was developed incorporating pregnancy-induced physiological changes and placental transfer. Simulations were performed to evaluate current dosing recommendations and alternative dosing scenarios were explored. To avoid maternal dose-related toxicity (QT-prolongation), we aimed for maternal concentrations < 2.5 mg/L. Based on neonatal concentration-effect data, we aimed for fetal C
resultsModel predictions for maternal and fetal plasma concentrations were generally consistent with available maternal and fetal exposure data. Simulations showed that at the maximum oral daily dose of 480 mg, 16% of maternal concentrations exceeded the toxicity threshold, while 90% of fetuses had therapeutic C
conclusionPregnancy PBPK modeling is a valuable tool for optimizing fetal sotalol therapy. A daily dose not exceeding 400 mg, or dividing daily doses of 240 mg and higher into three administrations, may optimize the balance between predicted fetal efficacy and maternal toxicity risk.
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