Renal Dose Adjustment (Based on CrCl)
- 10-50 mL/min: Decrease dose by 50%
- < 10 mL/min: Avoid use
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- Oral terbutaline sulfate has not been approved and should not be used for acute or maintenance tocolysis. In particular, terbutaline sulfate should not be used for maintenance tocolysis in the outpatient or home setting [US black box warning]
- Serious adverse reactions, including death, have been reported after administration of terbutaline sulfate to pregnant women. In the mother, these adverse reactions include increased heart rate, transient hyperglycemia, hypokalemia, cardiac arrhythmias, pulmonary edema and myocardial ischemia [US black box warning]
- Increased fetal heart rate and neonatal hypoglycemia may occur as a result of maternal administration[US black box warning]
- Deterioration of asthma may occur. If patient need more doses of terbutaline than usual, reevalaute treatment regimen. Destabilization of asthma may require treatment with corticosteroids
- Beta-adrenergic agonist bronchodilators alone may not be adequate to control asthma. Incorporation of corticosteroids early in therapy is recommended
- Acute hypersensitivity reactions and exacerbation of bronchospasm have been reported after terbutaline administration
- Safety and efficacy in children younger than 12 yr of age not established
Cautions: Use cautiously in
- Cardiovascular disease
- Hypertension
- CAD
- Cardiac arrhythmias
- Diabetes mellitus
- Hyperthyroidism
- History of seizure disorder
- Pregnancy
- Lactation
Pregnancy Category:B
Breastfeeding: Maternal use of oral terbutaline is unlikely to affect a breastfed infant. This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776) and based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 30 April 2010).
