There are several contraindications to the administration of terbutaline, including Breastfeeding and pregnancy. These are discussed in the following article. Long-term use in patients with asthma and recurrent preterm labour is also discussed. However, there is no clear-cut rule on when this medicine should be stopped. If you’re unsure, talk to your doctor.
Breast-feeding
There are no known contraindications to breastfeeding while using terbutaline. It has low bioavailability and a low maternal serum level, so its use as a tocolytic agent might decrease the duration of breastfeeding. However, a retrospective survey in Serbia found that mothers who took a beta-agonist pharmacologically equivalent to terbutaline for tocolytic purposes breastfed for fewer hours than those who did not use a tocolytic. Hence, terbutaline as a tocolytic is not likely to have a similar effect on breastfeeding duration.
Despite these concerns, the vast majority of scientific studies on terbutaline have reported its safety in breastfeeding. According to the DrLact safety Version 1.2 model, terbutaline is safe for use during pregnancy and lactation. Its safety is assessed according to the DrLact safety index (DSI) score, which is a rating from 0 to 8. It uses publicly available data and case studies to determine whether the drug is safe to use during pregnancy and lactation.
Pregnancy
The use of terbutaline by injection is clinically appropriate only during labour and delivery in a hospital setting. Prolonged use may cause heart problems in the mother and fetal death. Because of these risks, this drug should not be administered to pregnant women in an outpatient or home setting. The FDA made this decision based on recent safety information, post-marketing reports, and data in the medical literature.
Terbutaline is administered to pregnant women through oral and subcutaneous routes. If administered intravenously, clinicians must monitor fluid balance, cardiac status, and electrolytes. The infusion rate should be increased slowly every ten to fifteen minutes to a maximum rate of 80 ug/min. If administered orally, terbutaline undergoes significant first-pass metabolism in the gastrointestinal tract, with an average half-life of 3.7 hours. Usual oral dosages range from 2.5 to 5 mg every four to six hours.
Long-term use in patients with asthma
Terbutaline is a bronchodilator medication used to ease symptoms of breathing problems, including wheezing, shortness of breath, and asthma. It can help patients stay active by reducing the amount of time they need to miss work. It also decreases the amount of time a patient is required to spend resting from work. Although the drug is quite popular, it is important to remember that it is not safe to take if you are pregnant or breastfeeding.
In this study, children with asthma were given oral terbutaline, at progressively increasing doses. Patients’ steady-state plasma concentrations were similar between those in the control group and those in the asthmatic group, despite the fact that the doses were not significantly different. The same study also found no differences in side effects between patients with asthma and those with healthy children. The benefits of terbutaline use are unclear, but more studies are needed to make an informed decision for each patient.
Long-term use in patients with recurrent preterm labour
The FDA has issued a caution for the long-term use of terbutaline sulfate in patients with recurrent preterm labour. This medication is effective in delaying labour for a few hours, but it can also cause serious cardiovascular effects in the mother. As such, the FDA warns against using terbutaline at home.
Although long-term use of terbutaline may be clinically appropriate for specific obstetric situations in the hospital, prolonged use of this medication can cause serious complications, including cardiac problems and maternal death. The FDA’s warning letter to healthcare professionals warns against the risks of terbutaline. It also urges the use of alternative therapies for patients with recurrent preterm labour.
A prospective, randomized double-blind trial comparing oral terbutaline with intravenous ritodrine found no significant difference in outcome between the two treatment methods. In both groups, the dosage of terbutaline was titrated to the lowest effective dose, and patients with intact membranes were switched to oral therapy. Both treatments reduced the risk of recurrent preterm labour, but neither treatment prevented recurrence.
