• Management of reversible airway disease due to asthma (subcut used for short-term control and oral agent as long-term control).

Unlabeled Use:

• Management of preterm labor (tocolytic) (terbutaline injection may only be used for the short-term [≤72 hr]) management of preterm labor to prolong pregnancy and allow for the administration of antenatal steroids).

Contraindicated in:

• Hypersensitivity to adrenergic amines.

Use Cautiously in:

• Cardiac disease
• Hypertension
• Hyperthyroidism
• Diabetes
• Glaucoma
• OB: Use for bronchodilation in pregnancy only if potential maternal benefit justifies potential fetal risk
• Geri: Older adults are more susceptible to adverse reactions (may require dose ↓).

CV: angina, arrhythmias, hypertension, myocardial ischemia, tachycardia.

Endo: hyperglycemia.

F and E: hypokalemia.

GI: nausea, vomiting.

Neuro: nervousness, restlessness, tremor, headache, insomnia.

Resp: pulmonary edema.

Drug-Drug:

• Concurrent use with other adrenergics (sympathomimetic) will have additive adrenergic side effects.
• Use with MAO inhibitors may lead to hypertensive crisis.
• Beta blockers may negate its therapeutic effect.

Drug-Natural Products:

• Use with caffeine-containing herbs (cola nut, guarana, mate, tea, coffee) ↑ stimulant effect.

(Generic available)

• Tablets: 2.5 mg; 5 mg;
• Solution for injection: 1 mg/mL;

Asthma

• PO (Adults and Children >15 yr): 2.5–5 mg 3 times daily, given every 6 hr (not to exceed 15 mg/24 hr).
• PO (Children 12–15 yr): 2.5 mg 3 times daily (given every 6 hr) (not to exceed 7.5 mg/24 hr).
• PO (Children <12 yr): 0.05 mg/kg 3 times daily; may ↑ gradually (not to exceed 0.15 mg/kg 3–4 times daily or 5 mg/24 hr).
• SC (Adults and Children ≥12 yr): 250 mcg; may repeat in 15–30 min (not to exceed 500 mcg/4 hr).
• SC (Children <12 yr): 0.005–0.01 mg/kg; may repeat in 15–20 min.

Tocolysis (off-label)

• IV (Adults): 2.5–10 mcg/min infusion; ↑ by 5 mcg/min every 10 min until contractions stop (not to exceed 30 mcg/min). After contractions have stopped for 30 min, ↓ infusion rate to lowest effective amount and maintain for 4–8 hr.

• Results in the accumulation of cyclic adenosine monophosphate (cAMP) at beta-adrenergic receptors.
• Produces bronchodilation.
• Inhibits the release of mediators of immediate hypersensitivity reactions from mast cells.
• Relatively selective for beta₂(pulmonary)-adrenergic receptor sites, with less effect on beta₁(cardiac)-adrenergic receptors.

• Bronchodilation.

Therapeutic Classification: bronchodilators

Pharmacologic Classification: adrenergics

Absorption: 35–50% absorbed following oral administration but rapidly undergoes first-pass metabolism. Well absorbed following SUBQ administration.

Distribution: Unknown.

Metabolism/Excretion: Partially metabolized by the liver; 60% excreted unchanged by the kidneys.

Half-life: 5.7 hr.

Bricanyl Turbuhaler

(bronchodilation)

• Instruct patient to take medication as directed. If on a scheduled dosing regimen, take a missed dose as soon as possible; space remaining doses at regular intervals. Do not double doses. Caution patient not to exceed recommended dose; may cause adverse effects, paradoxical bronchospasm, or loss of effectiveness of medication.
  • Instruct patient to contact health care professional immediately if shortness of breath is not relieved by medication or is accompanied by diaphoresis, dizziness, palpitations, or chest pain.
  • Advise patient to consult health care professional before taking any OTC medications or alcoholic beverages concurrently with this therapy. Caution patient also to avoid smoking and other respiratory irritants.
• Preterm Labor: Notify health care professional immediately if labor resumes or if significant side effects occur.

ter-BYOO-ta-leen

NDC Code^*

• 0115- Amneal Pharmaceuticals of New York LLC
  • 0115-2611- TERBUTALINE SULFATE
    • 0115-2611-01- 100 TABLET in 1 BOTTLE (0115-2611-01)

• 0115- Amneal Pharmaceuticals of New York LLC
  • 0115-2611- TERBUTALINE SULFATE
    • 0115-2611-02- 500 TABLET in 1 BOTTLE (0115-2611-02)

• 0115- Amneal Pharmaceuticals of New York LLC
  • 0115-2611- TERBUTALINE SULFATE
    • 0115-2611-03- 1000 TABLET in 1 BOTTLE (0115-2611-03)

• 0115- Amneal Pharmaceuticals of New York LLC
  • 0115-2622- TERBUTALINE SULFATE
    • 0115-2622-01- 100 TABLET in 1 BOTTLE (0115-2622-01)

• 0115- Amneal Pharmaceuticals of New York LLC
  • 0115-2622- TERBUTALINE SULFATE
    • 0115-2622-02- 500 TABLET in 1 BOTTLE (0115-2622-02)

• 0115- Amneal Pharmaceuticals of New York LLC
  • 0115-2622- TERBUTALINE SULFATE
    • 0115-2622-03- 1000 TABLET in 1 BOTTLE (0115-2622-03)

• 0143- West-Ward Pharmaceuticals Corp
  • 0143-9746- Terbutaline Sulfate
    • 0143-9746-10- 10 VIAL in 1 CARTON (0143-9746-10) > 1 mL in 1 VIAL (0143-9746-01)

• 0527- Lannett Company, Inc.
  • 0527-1311- Terbutaline Sulfate
    • 0527-1311-01- 100 TABLET in 1 BOTTLE (0527-1311-01)

• 0527- Lannett Company, Inc.
  • 0527-1311- Terbutaline Sulfate
    • 0527-1311-10- 1000 TABLET in 1 BOTTLE (0527-1311-10)

• 0527- Lannett Company, Inc.
  • 0527-1318- Terbutaline Sulfate
    • 0527-1318-01- 100 TABLET in 1 BOTTLE (0527-1318-01)

• 0527- Lannett Company, Inc.
  • 0527-1318- Terbutaline Sulfate
    • 0527-1318-10- 1000 TABLET in 1 BOTTLE (0527-1318-10)

• 52584- General Injectables and Vaccines, Inc
  • 52584-665- Terbutaline Sulfate
    • 52584-665-01- 1 VIAL in 1 BAG (52584-665-01) > 1 mL in 1 VIAL

• 62559- ANI Pharmaceuticals, Inc.
  • 62559-721- Terbutaline Sulfate
    • 62559-721-01- 100 TABLET in 1 BOTTLE (62559-721-01)

• 62559- ANI Pharmaceuticals, Inc.
  • 62559-722- Terbutaline Sulfate
    • 62559-722-01- 100 TABLET in 1 BOTTLE (62559-722-01)

• 63323- Fresenius Kabi USA, LLC
  • 63323-665- Terbutaline Sulfate
    • 63323-665-01- 25 VIAL, SINGLE-USE in 1 TRAY (63323-665-01) > 1 mL in 1 VIAL, SINGLE-USE

• 70860- Athenex Pharmaceutical Division, LLC.
  • 70860-801- Terbutaline Sulfate
    • 70860-801-01- 10 VIAL in 1 CARTON (70860-801-01) > 1 mL in 1 VIAL (70860-801-41)

• 71872- Medical Purchasing Solutions. LLC
  • 71872-7080- Terbutaline Sulfate
    • 71872-7080-1- 1 VIAL in 1 BAG (71872-7080-1) > 1 mL in 1 VIAL

• 71872- Medical Purchasing Solutions, LLC
  • 71872-7130- Terbutaline Sulfate
    • 71872-7130-1- 1 VIAL in 1 BAG (71872-7130-1) > 1 mL in 1 VIAL

• 72843- UBI Pharma Inc.
  • 72843-101- Terbutaline Sulfate
    • 72843-101-10- 10 VIAL in 1 BOX (72843-101-10) > 1 mL in 1 VIAL