Terbutaline sulfate is a bronchodilator, which means it opens the airways. It is used to treat breathing problems, such as asthma. Terbutaline sulfate also has other uses, including stopping premature contractions in pregnant women. It can be given orally as a pill or inhalant, or subcutaneously through injection or continuous infusion.
The approved use of terbutaline sulfate is for the treatment of bronchospasm in patients 12 years and older. Bronchospasm is abnormal contraction of the bronchi, which causes difficulty in breathing. For bronchospasm, the typical dose is 0.25 mg, injected subcutaneously. If the symptoms do not respond in 15 to 30 minutes, a second dose can be given.
Terbutaline sulfate may not be enough to sufficiently control symptoms in asthmatic patients. Patients who need to use this drug often may benefit from the addition of corticosteroids. The dosage of corticosterioids should not exceed 15 mg over 24 hours.
Although it is an off-label use, terbutaline sulfate is sometimes used to stop premature contractions. It is thought to achieve this by relaxing the uterine muscles. Studies have shown terbutaline sulfate is effective at stopping labor for 24 to 48 hours. Some studies have shown it to be effective after this time, while others have not.
In 1997, the Food and Drug Administration (FDA) in the United States released a warning about use of terbutaline sulfate via infusion pump to stop labor for periods greater than 72 hours. Many women experienced chest pain and pulmonary edema, and at least one death was reported. Since the pump is prescribed for out-patient use, side effects cannot be constantly monitored.
Halting labor for only a few days does have some benefits. Generally, the earliest health care providers will attempt life support for a premature baby is 24 weeks into the pregnancy. A few extra days may be necessary to get to that point. The extra time also allows for the administration of corticosteroids. Steroids can help speed up the development of the baby's lungs, and the two injections typically given must be 24 hours apart.
Patients with certain medical conditions should use this drug with caution. Those with diabetes, heart disease, a history of seizures, or who are breast feeding should discuss their conditions with their health care provider before using this drug. Terbutaline sulfate may interact with monoamine oxidase inhibitors, procarbazine, and probucol.
The most common side effects include drowsiness, nervousness, nausea, headache, and tremors. Serious side effects include allergic reaction, hallucinations, irregular heartbeat, and seizures. Pulmonary edema has been reported during use for the prevention of preterm labor.
