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Terbutaline Sulfate

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Terbutaline Sulfate

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SIDE EFFECTS

Adverse reactions observed with terbutaline are similar to those commonly seen with other sympathomimetic agents. All these reactions are transient in nature and usually do not require treatment.

The following table compares adverse reactions seen in patients treated with terbutaline sulfate injection (0.25 mg and 0.5 mg), with those seen in patients treated with epinephrine injection (0.25 mg and 0.5 mg), during eight double-blind crossover studies involving a total of 214 patients.

Incidence (%) of Adverse Reactions

  Terbutaline (%) Epinephrine (%)
0.25 mg 0.5 mg 0.25 mg 0.5 mg
N=77 N=205 N=153 N=61
Reaction  
Central Nervous System
  Tremor 7.8 38.0 16.3 18.0
  Nervousness 16.9 30.7 8.5 31.1
  Dizziness 1.3 10.2 7.8 3.3
  Headache 7.8 8.8 3.3 9.8
  Drowsiness 11.7 9.8 14.4 8.2
Cardiovascular
  Palpitations 7.8 22.9 7.8 29.5
  Tachycardia 1.3 1.5 2.6 0.0
Respiratory
  Dyspnea 0.0 2.0 2.0 0.0
  Chest discomfort 1.3 1.5 2.6 0.0
Gastrointestinal
  Nausea/vomiting 1.3 3.9 1.3 11.5
Systemic
  Weakness 1.3 0.5 2.6 1.6
  Flushed feeling 0.0 2.4 1.3 0.0
  Sweating 0.0 2.4 0.0 0.0
  Pain at injection site 2.6 0.5 2.6 1.6
Note: Some patients received more than one dosage strength of terbutaline sulfate and epinephrine. In addition, there were reports of anxiety, muscle cramps, and dry mouth ( < 0.5%). There have been rare reports of elevations in liver enzymes and of hypersensitivity vasculitis with terbutaline administration.

DRUG INTERACTIONS

The concomitant use of terbutaline with other sympathomimetic agents is not recommended, since the combined effect on the cardiovascular system may be deleterious to the patient.

Monoamine Oxidase Inhibitors or Tricyclic Antidepressants

Terbutaline should be administered with extreme caution to patients being treated with monoamine oxidase inhibitors or tricyclic antidepressants, or within 2 weeks of discontinuation of such agents, since the action of terbutaline on the vascular system may be potentiated.

Beta-Blockers

Beta-adrenergic receptor blocking agents not only block the pulmonary effect of beta-agonists, such as terbutaline, but may produce severe bronchospasm in asthmatic patients. Therefore, patients with asthma should not normally be treated with beta-blockers. However, under certain circumstances, e.g., as prophylaxis after myocardial infarction, there may be no acceptable alternatives to the use of beta-adrenergic blocking agents in patients with asthma. In this setting, cardioselective beta-blockers could be considered, although they should be administered with caution.

Diuretics

The ECG changes and/or hypokalemia that may result from the administration of nonpotassium-sparing diuretics (such as loop or thiazide diuretics) can be acutely worsened by beta-agonists, especially when the recommended dose of the beta-agonist is exceeded. Although the clinical significance of these effects is not known, caution is advised in the coadministration of beta-agonists with nonpotassium-sparing diuretics.

Last reviewed on RxList: 5/28/2008
This monograph has been modified to include the generic and brand name in many instances.

Additional Terbutaline Sulfate Information

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