Clinical Pharmacology Details


TERBUTALINE


View Drug Forms

Indications & Dose:

Asthma


Other conditions associated with reversible airways obstruction



Adult: Initially 2.5 mg 3 times a day for 1–2 weeks, then increased to up to 5 mg 3 times a day, use by inhalation preferred over by mouth



Adult: 250–500 micrograms up to 4 times a day, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect



Adult: 90–300 micrograms/hour for 8-10 hours, to be administered as a solution containing 3–5 micrograms/mL, high doses require close monitoring, reserve intravenous continued beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect



Adult: 500 micrograms up to 4 times a day, for persistent symptoms



Adult: 5–10 mg 2–4 times a day, additional doses may be necessary in severe acute asthma Acute asthma



Child 2–14 years: 10 micrograms/kg up to 4 times a day (max. per dose 300 micrograms), reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect Child 15–17 years: 250–500 micrograms up to 4 times a day, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect



Child: Loading dose 2–4 micrograms/kg, then 1– 10 micrograms/kg/hour, dose to be adjusted according to response and heart rate, close monitoring is required for doses above 10 micrograms/kg/hour, reserve intravenous beta2 agonists for those in whom inhaled therapy cannot be used reliably or there is no current effect


Moderate, severe, or life-threatening acute asthma



Child 1 month–4 years: 5 mg, repeat every 20–30 minutes or when required, give via oxygendriven nebuliser if available


Child 5–11 years: 5–10 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available


Child 12–17 years: 10 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available


Adult: 10 mg, repeat every 20–30 minutes or when required, give via oxygen-driven nebuliser if available


Exacerbation of reversible airways obstruction (including nocturnal asthma) | Prevention of exercise-induced bronchospasm



Child 5–17 years: 500 micrograms up to 4 times a day, for occasional use only



Child 1 month–6 years: 75 micrograms/kg 3 times a day (max. per dose 2.5 mg), administration by mouth is not recommended


Child 7–14 years: 2.5 mg 2–3 times a day, administration by mouth is not recommended


Child 15–17 years: Initially 2.5 mg 3 times a day, then increased if necessary to 5 mg 3 times a day, administration by mouth is not recommended


Uncomplicated premature labour (between 22 and 37 weeks of gestation) (specialist supervision in hospital)



Adult: Initially 5 micrograms/minute for 20 minutes, then increased in steps of 2.5 micrograms/minute every 20 minutes until contractions have ceased (more than 10 micrograms/minute should seldom be given—20 micrograms/minute should not be exceeded), continue for 1 hour, then reduced in steps of 2.5 micrograms/minute every 20 minutes to lowest dose that maintains suppression (maximum total duration 48 hours)


OR


Adults


Oral: 1/2 tablet or 10ml syrup three times in 24 hour, increasing to 1 tablet or 15ml syrup three times in 24 hours if necessary: min; dose interval 7 hours. s.c, i.m., Slow i.v: 0.25-0.5mg upto 4 times daily.


Aerosol Inhalation: 250-500mcg (1-2 puffs); for persistent symptoms upto 3-4 times daily, max; 8 puffs in 24 hours


Nebulised soln. inhalation: 5-10mg 2-4 times daily in nebulizer


Children


Oral: 0.25ml syrup three times in 24 hour, 7-15 years, initially 1/2 tablet twice in 24 hours, if necessary: min; dose interval 7 hours. s.c, i.m., Slow i.v: under 2 years not recommended; 2-15 years 10microgram/kg by s.c, i.m, or slow i.v, inj, total max; 300 microgram.


Aerosol Inhalation: under 25kg , use respirator solution, over 25 kg, 5 mg two to four times daily in a nebulizer.


Nebulised soln. inhalation: 2-5 mg diluted and nebulised two to four times daily. 

Contraindications:

Side Effects:

CNS: Anxiety, dizziness, headache, insomnia, nervousness, shakiness, tremor


CV: Angina, cardiac arrest, dysrhythmias, hypertension, palpitations, tachycardia


GI: Elevated liver enzymes, nausea, vomiting 

Cautions:

Precautions:

Interaction:

Drugs


Beta-blockers: Decreased action of terbutaline, cardioselective betablockers preferable if concurrent use necessary; metoprolol inhibits terbutaline metabolism


Furosemide: Potential for additive hypokalemia 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: