Terbutaline sulfate is available in 1-mL ampuls and single-dose or single-use vials.3655; 3656; 3657; 3658 Each mL contains terbutaline sulfate 1 mg, sodium chloride for isotonicity, and hydrochloric acid to adjust the pH.3655; 3656; 3657; 3658 Some products also contain edetate disodium dihydrate.3658
pH
The pH of terbutaline sulfate is adjusted to a target of 43655; 3656; 3658 or a range of 3 to 5.3657
Equivalency
Terbutaline sulfate 1 mg is equivalent to 0.82 mg of terbutaline free base.3655; 3656; 3657; 3658
Terbutaline sulfate injection is administered subcutaneously only, usually into the lateral deltoid area.3655; 3656; 3657; 3658 Intravenous administration is not recommended by manufacturers,3655; 3656; 3657; 3658 but has been used in selected patients.3659; 3660
Intact ampuls and vials of terbutaline sulfate should be stored at controlled room temperature in the original carton to protect from light.3655; 3656; 3657; 3658 Discolored solutions should not be used.3655; 3656; 3657; 3658
Terbutaline sulfate is relatively stable compared with other catecholamines.738
Syringes
The stability of terbutaline sulfate (Geigy) 1 mg/mL was studied packaged in polypropylene syringes (Becton Dickinson) fitted with luer-tip caps (Becton Dickinson). The samples were stored at 4°C in the dark, 25°C in the dark, and 25°C with exposure to fluorescent light. Samples stored in the dark at both temperatures were stable, exhibiting a 5 to 6% drug loss in 60 days. The 25°C samples exposed to light showed a 5% loss in 28 days and an 11% loss in 60 days with a yellow discoloration.1298
The stability of terbutaline sulfate (Geigy) 1 mg/mL repackaged in syringes was evaluated. A 0.25-mL sample was drawn into each plastic tuberculin syringe (Becton Dickinson) and sealed with a luer-tip cap (Becton Dickinson). Samples were stored at 4 and 24°C with exposure to light and light protection. Little difference was reported in the terbutaline sulfate content among the 4 storage conditions. Drug losses of 5% or less were observed after 7 weeks of storage. Although no discoloration was reported, it may not have been observed in the small sample present in the tuberculin syringe.1299
Standardize 4 Safety
One or more standardized concentrations for this drug have been established through Standardize 4 Safety (S4S), a national patient safety initiative to reduce medication errors, especially during transitions of care. (See Standardize 4 Safety in Users Guide.) Recommendations developed to date through this initiative are available at www.ashp.org/pharmacy-practice/standardize-4-safety-initiative.
Table 1: Standardize 4 Safety Continuous IV Infusion Standard Concentrations for Terbutaline3635
| Patient Population | Concentration Standards | Dosing Units |
|---|---|---|
| Pediatric patients (50 kg) | 1 mg/mL | mcg/kg/minute (note dosing units differ from concentration units) |
For a list of references cited in the text of this monograph, search the monograph titled References.