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Terbutaline information from DrugsUpdate  

See Available Brands of Terbutaline in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Terbutaline, a bronchodilator, is prescribed for the treatment of bronchospasms associated with emphysema, asthma and bronchitis. Terbutaline relaxes airway muscles to improve pulmonary functions and breathing. 

Pharmacodynamics

Pharmacokinetics

Terbutaline is a direct-acting sympathomimetic which relaxes bronchial smooth muscle by selective action on β2 receptors. It also decreases uterine contractility.

Onset
Inhalation: 5 minutes; Oral: 30 minutes.

Duration
Inhalation: 3-4 hours; Oral: 8 hours.

Absorption

Absorbed from the GI tract.

Distribution
Some amounts cross the placenta and appear in breast milk. Half-life: 3 to 4 hours.

Metabolism
60% of absorbed dose undergoes first-pass metabolism by sulphate conjugation in the liver and gut wall.

Excretion

Via the urine partly as inactive conjugates and partly as unchanged drug.

Terbutaline Indications / Terbutaline Uses

Information Not Available

Terbutaline Adverse Reactions / Terbutaline Side Effects

Terbutaline may interact with chest pain, arrhythmia, allergic reactions, headache, dry mouth, tremor, insomnia, dizziness, sweating and GI disturbances. 

Precautions

Terbutaline is contraindicated in patients with renal disorders, liver diseases, heart diseases, diabetes, epilepsy, hyperthyroidism and hypertension. 

Special Precautions

Arrhythmias, hyperthyroidism, hypertension, diabetes, myocardial insufficiency, history of seizures, heart disease.

Other Drug Interactions

Terbutaline may interact with caffeine, decongestants, tricyclic anti-depressants, beta-blockers, MAOIs and diet pills.

Other Interactions

Information Not Available

Dosage

For Asthma – Maintenance (Adults):
As tablets, start with an initial dose of 5 mg, thrice daily with six hours apart during waking hours. In case of adverse events, 2.5 mg/dose can be reduced. The total cumulative dose should not exceed 15 mg/day.
As an inhalation aerosol, inhale 2 puffs with one minute apart for every 4-6 hours.
For Premature Labor (Adults):
As tablets, consider oral administration of 2.5-7.5 mg, every 6 hours. The treatment should be continued until 36-37 weeks of pregnancy.
As continuous IV infusion, consider administration of 10-25 mcg/min. The infusion should be considered until needed. The maximum dose should not exceed 80 mcg/min.
As SC injection, consider administration of 0.25 mg of Terbutaline, every 6 hours, until needed.
 
For Asthma – Acute (Adults):

As an inhalation aerosol, inhale 2 puffs with one minute apart for every 4-6 hours.
As SC injection, consider administration of 0.25 mg of Terbutaline into the lateral deltoid muscle. If needed, second dose of 0.25 mg can be administered within 15-30 minutes. The total cumulative dose should not exceed 0.5 mg in four hours.
As continuous IV infusion, consider administration 0.08 – 6 mcg/kg/min.

For Asthma – Acute (Pediatric):

As SC injection, consider administration of 0.005-0.01 mg/kg/dose of Terbutaline. If needed, second dose of 0.4 mg can be administered within 15-30 minutes.
As continuous IV infusion, consider administration 0.08 – 6 mcg/kg/min.
As nebulization, consider 0.01-0.03 mg/kg/dose of Terbutaline. The maximum dose should not exceed 2.5 mg (diluted in 1-2 ml of 0.9% saline), every 4-6 hours.
As inhalation aerosol, for children > 12 years of age, inhale 2 puffs with one minute apart for every 4-6 hours.
As SC injection, consider administration of 0.25 mg of Terbutaline into the lateral deltoid muscle. If needed, second dose of 0.25 mg can be administered within 15-30 minutes. The total cumulative dose should not exceed 0.5 mg in four hours.
 
For Asthma – Maintenance (Pediatric):

For children, < 12 years, consider administration of 0.05 mg/kg/day in three divided doses. The doses can be gradually increased to 0.15 mg/kg/day. The maximum daily dose should not exceed 5 mg.
As inhalation aerosol, for children >=12 years of age, inhale 2 puffs with one minute apart for every 4-6 hours.
For children, >=12 <15 years, consider administration of 2.5 mg oral tablets, every 6-8 hours. The maximum cumulative daily dose should not exceed 7.5 mg.
For children, <=15 years, consider administration of 2.5-5 mg oral tablets, every 6-8 hours. The maximum cumulative daily dose should not exceed 15 mg.

Food(before/after)

Terbutaline can be taken before or after food intake

List of Contraindications

Terbutaline and Pregnancy

USFDA pregnancy category B. Terbutaline may not cause harm to an unborn foetus. Before Terbutaline treatment, the patient should discuss with the physician, if they are planning for a pregnancy.

Terbutaline and Lactation

Terbutaline can pass through the breast milk, and harm a nursing infant. Terbutaline should be avoided in nursing mothers.

Terbutaline and Children

Terbutaline is not recommended for patients under the age of 12 years because of insufficient clinical data to establish safety and effectiveness.

Terbutaline and Geriatic

No specific information

Terbutaline and Other Contraindications

Hypersensitivity to sympathomimetics. Any condition of mother or foetus in which prolongation of pregnancy is dangerous.

Storage

Store at 20-25°C.

Lab interference

Store at 20-25°C.

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