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terbutaline (Rx)Brand and Other Names:Brethaire, Brethine, more...Bricanyl

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 2.5mg
  • 5mg

injectable solution

  • 1mg/mL
more...

Bronchospasm

PO

  • Initiate at 2.5 mg three/four times daily PO
  • Maintenance: 5 mg three times daily PO q6hr while patient is awake; reduce dose to 2.5 mg q6hr
  • Not to exceed 15 mg/Day

SC

  • 0.25 mg q15-30min x 3 doses PRN in lateral deltoid
  • Not to exceed 0.5 mg/4 hr

Preterm Labor (Off-label)

Initiate at 2.5-5 mcg/min IV

Increase gradually as tolerated at 20-30 minute intervals

Typical effective dose ranges between 17.5-30 mcg/min IV; some require doses up to 70-80 mcg/min

Continue infusion for 12 hr following cessation of uterine contractions; not to exceed 48-72 hr

PO use or prolonged IV use not recommended (see Black Box Warnings)

Renal Impairment

GFR <50 mL/min: reduce dose by 50%

GFR >50mL/min: Dose adjustment not necessary

Dosage Forms & Strengths

tablet

  • 2.5mg
  • 5mg

injectable solution

  • 1mg/mL
more...

Bronchospasm

PO

  • <12 years: 0.05 mg/kg three times daily initially; increase PRN, not to exceed 5 mg/day 
  • 12-15 years: 2.5 mg PO q6hr 3 times daily; not to exceed 7.5 mg/day
  • >15 years: 5 mg/dose PO q8hr three times daily; reduce dose to 2.5 mg q6hr; not to exceed 15 mg/24hr

SC (in lateral deltoid)

  • <12 years: 0.005-0.01 mg/kg (no more than 0.4 mg) q15-20min x 3; THEN q2-6hour PRN 
  • >12 years: 0.25 mg q15-30min x 3 doses PRN in lateral deltoid; not to exceed 0.5 mg/4 hr
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Interactions

Interaction Checker

terbutaline and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Nervousness

            Restlessness

            Transient hyperglycemia

            Transient hypokalemia

            Trembling

            Tachycardia

            HTN

            Pounding heartbeat

            Dizziness

            Lightheadedness

            Drowsiness

            Headache

            Insomnia

            Dry mouth

            Nausea

            Vomiting

            Bad taste in mouth

            Muscle cramps

            Weakness

            Diaphoresis

            Cardiac arrhythmias

            Pulmonary edema

            Myocardial ischemia

            Myocardial infarction

            Increased fetal heart rate

            Hypoglycemia in some neonates born to women who received drug during labor

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            Warnings

            Black Box Warnings

            Risk of serious adverse events outweighs potential benefit to pregnant women receiving prlonged treatment with terbutaline injection (ie, >48-72 hr), or acute or prolonged treatment with oral terbutaline

            Oral terbutaline should not be used for prevention or any treatment of preterm labor because efficacy has not been established and safety concerns similar to IV administration exist

            Death and serious adverse reactions have been reported following prolonged administration of oral or injectable terbutaline to pregnant women

            Serious events following prolonged use include tachycardia, transient hyperglycemia, hypokalemia, arrhythmias, pulmonary edema, and myocardial ischemia

            Contraindications

            Hypersensitivity to sympathomimetics

            Use >72 hr in management or prevention of preterm labor

            Oral administration in preterm labor

            Cautions

            Diabetes mellitus

            Hypertension

            Hyperthyroidism

            History of seizures

            History of cardiac disease, including ischemic heart disease or associated arrhythmias

            Paradoxical bronchoconstriction may occur with excessive use

            Fatalities reported with excessive use of sympathomimetics

            Optimize anti-inflammatory treatment prior to administering terbutaline for asthma therapy

            Beta-2 agonists may increase serum glucose; use caution in patients with diabetes mellitus

            Use caution in glaucoma, hyperthyroidism, seizure disorders, and hypokalemia

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Distributed into breast milk, but in amounts generally considered insufficient to affect nursing infants (AAP Committee states compatible with nursing)

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Beta adrenergic receptor stimulator causing bronchial/uterine smooth muscle relaxation

            Pharmacokinetics

            Onset: 30-45 min (PO); 6-15 min (SC)

            Duration: 90 min-4 hr

            Peak plasma time: 30-60 min

            Half-life: 11-16 hr

            Protein binding: 25%

            Absorbtion: 33-50%

            Metabolism: Partially metabolized in liver, mainly to inactive sulfate conjugate

            Excretion: 60% urine unchanged, up to 3% feces via bile; remainder in urine as the conjugate (w/ parenteral admin)

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            Administration

            IV Preparation

            Solution: dilute as required in D5W (available form: 1 mg/mL)

            Administration: use infusion pump

            Protect inj from light

            Do not use if discolored

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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