clear, use caution. Use Caution/Monitor.telmisartanMonitor Closely (1)telmisartan increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.temazepamMonitor Closely (1)temazepam increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thioridazineMonitor Closely (1)thioridazine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.thiothixeneMonitor Closely (1)thiothixene increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.timololMonitor Closely (2)timolol decreases effects of terbutaline by pharmacodynamic antagonism. Use Caution/Monitor. timolol increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.tolfenamic acidMonitor Closely (1)tolfenamic acid increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.tolmetinMonitor Closely (1)tolmetin increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.tolvaptanMonitor Closely (1)tolvaptan increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.topiramateMonitor Closely (1)topiramate increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.torsemideMonitor Closely (1)terbutaline and torsemide both decrease serum potassium. Use Caution/Monitor.Minor (2)terbutaline, torsemide. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Hypokalemia. torsemide, terbutaline. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Additive hypokalemic effects.tramadolMonitor Closely (1)tramadol increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.tranylcypromineSerious - Use Alternative (1)tranylcypromine increases effects of terbutaline by pharmacodynamic synergism. Contraindicated. Risk of acute hypertensive episode.trazodoneMonitor Closely (1)trazodone increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trazodone, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.triamtereneMonitor Closely (1)triamterene increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.triazolamMonitor Closely (1)triazolam increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.triclofosMonitor Closely (1)triclofos increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trifluoperazineMonitor Closely (1)trifluoperazine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.trimipramineMonitor Closely (1)trimipramine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Serious - Use Alternative (1)trimipramine, terbutaline. Other (see comment). Avoid or Use Alternate Drug. Comment: Tricyclic antidepressants increase or decrease effects of sympathomimetics, by blocking reuptake of NE, or blocking uptake of indirect sympathomimetics into the adrenergic neuron.triprolidineMonitor Closely (1)triprolidine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.valsartanMonitor Closely (1)valsartan increases and terbutaline decreases serum potassium. Effect of interaction is not clear, use caution. Use Caution/Monitor.xylometazolineMonitor Closely (2)terbutaline and xylometazoline both decrease sedation. Use Caution/Monitor. terbutaline and xylometazoline both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.yohimbineMonitor Closely (2)terbutaline and yohimbine both decrease sedation. Use Caution/Monitor. terbutaline and yohimbine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Use Caution/Monitor.ziconotideMonitor Closely (1)ziconotide increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.ziprasidoneMonitor Closely (1)ziprasidone increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. Frequency Not Defined Nervousness Restlessness Transient hyperglycemia Transient hypokalemia Trembling Tachycardia HTN Pounding heartbeat Dizziness Lightheadedness Drowsiness Headache Insomnia Dry mouth Nausea Vomiting Bad taste in mouth Muscle cramps Weakness Diaphoresis Cardiac arrhythmias Pulmonary edema Myocardial ischemia Myocardial infarction Increased fetal heart rate Hypoglycemia in some neonates born to women who received drug during labor Black Box Warnings Risk of serious adverse events outweighs potential benefit to pregnant women receiving prlonged treatment with terbutaline injection (ie, >48-72 hr), or acute or prolonged treatment with oral terbutaline Oral terbutaline should not be used for prevention or any treatment of preterm labor because efficacy has not been established and safety concerns similar to IV administration exist Death and serious adverse reactions have been reported following prolonged administration of oral or injectable terbutaline to pregnant women Serious events following prolonged use include tachycardia, transient hyperglycemia, hypokalemia, arrhythmias, pulmonary edema, and myocardial ischemiaContraindications Hypersensitivity to sympathomimetics Use >72 hr in management or prevention of preterm labor Oral administration in preterm labor Cautions Diabetes mellitus Hypertension Hyperthyroidism History of seizures History of cardiac disease, including ischemic heart disease or associated arrhythmias Paradoxical bronchoconstriction may occur with excessive use Fatalities reported with excessive use of sympathomimetics Optimize anti-inflammatory treatment prior to administering terbutaline for asthma therapy Beta-2 agonists may increase serum glucose; use caution in patients with diabetes mellitus Use caution in glaucoma, hyperthyroidism, seizure disorders, and hypokalemia Pregnancy Category: C Lactation: Distributed into breast milk, but in amounts generally considered insufficient to affect nursing infants (AAP Committee states compatible with nursing)Pregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Beta adrenergic receptor stimulator causing bronchial/uterine smooth muscle relaxation Pharmacokinetics Onset: 30-45 min (PO); 6-15 min (SC) Duration: 90 min-4 hr Peak plasma time: 30-60 min Half-life: 11-16 hr Protein binding: 25% Absorbtion: 33-50% Metabolism: Partially metabolized in liver, mainly to inactive sulfate conjugate Excretion: 60% urine unchanged, up to 3% feces via bile; remainder in urine as the conjugate (w/ parenteral admin) IV Preparation Solution: dilute as required in D5W (available form: 1 mg/mL) Administration: use infusion pump Protect inj from light Do not use if discolored BRAND FORM. UNIT PRICE PILL IMAGE terbutaline oral- 2.5 mg tabletterbutaline oral- 5 mg tabletterbutaline oral- 2.5 mg tabletterbutaline oral- 2.5 mg tabletterbutaline oral- 5 mg tabletterbutaline oral- 5 mg tabletterbutaline subcutaneous- 1 mg/mL vialterbutaline subcutaneous- 1 mg/mL vialterbutaline subcutaneous- 1 mg/mL vialterbutaline subcutaneous- 1 mg/mL vialterbutaline subcutaneous- 1 mg/mL vialterbutaline subcutaneous- 1 mg/mL vialCopyright © 2010 First DataBank, Inc.Select a drug:terbutaline oralterbutaline subcutaneousPrint Patient Educationterbutaline oral TERBUTALINE - ORAL (ter-BYOO-ta-leen) COMMON BRAND NAME(S): Brethine WARNING: Terbutaline should not be used to prevent or treat early labor, since it has risks to the mother that are greater than the benefits. Serious (sometimes fatal) side effects have rarely occurred in mothers taking terbutaline during labor, such as chest pain, fast/irregular heartbeats, and trouble breathing. If you are pregnant or become pregnant and are taking terbutaline for another medical condition (such as asthma), talk to your doctor or pharmacist about whether terbutaline is still right for you. USES: Terbutaline is used to treat wheezing and shortness of breath from lung problems (such as asthma, chronic obstructive pulmonary disease, bronchitis and emphysema). Controlling these symptoms can decrease time lost from work or school. Terbutaline belongs to a class of drugs known as bronchodilators. It works by relaxing the muscles around the airways so that they open up and you can breathe more easily. HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually 3 times daily. The dosage is based on your medical condition and response to treatment.Take this medication exactly as prescribed. Do not take more of this medication or take it more often than recommended by your doctor. If you have been directed to use this medication on a daily schedule, use it regularly at the same times each day in order to get the most benefit from it.If you take other asthma drugs by mouth or inhaling devices, ask your doctor about how to correctly take this medication with your other asthma medicines.If you notice less effect than usual from this medication, if your symptoms get worse, or if you feel you need to take any of your asthma medications more often than recommended, get medical help right away. SIDE EFFECTS: Nervousness, shaking (tremor), dizziness, drowsiness or headache may occur. If any of these effects last or get worse, notify your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may raise your blood pressure. Check your blood pressure regularly and tell your doctor if the results are high.Tell your doctor right away if you have any serious side effects, including: fast/pounding/irregular heartbeat, chest pain, muscle cramps, weakness, seizures.Rarely, this medication has caused severe (rarely fatal), sudden worsening of breathing problems/asthma (paradoxical bronchospasm). If you experience sudden wheezing, get medical help right away.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. See Warning Section.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Before taking terbutaline, tell your doctor or pharmacist if you are allergic to it; or to similar bronchodilators (such as albuterol, metaproterenol, salmeterol); or to sympathomimetic drugs (such as epinephrine, pseudoephedrine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: heart disease (such as irregular heartbeat, ischemic heart disease), high blood pressure, seizures, overactive thyroid (hyperthyroidism), diabetes, low blood potassium level (hypokalemia).This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially the effects on the heart.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. See Warning Section.Terbutaline passes into breast milk. Consult your doctor before breast-feeding. DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: unusual dizziness, dry mouth, severe headache, seizures, very fast heartbeat, severe nausea. NOTES: Do not share this medication with others.Lab and/or medical tests may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.Avoid allergens, irritants, smoking and other factors that make asthma worse.Learn to use a peak flow meter, use it daily, and promptly report worsening asthma (such as readings in the yellow/red range or increased use of quick-relief inhalers).Have your blood pressure and pulse checked regularly while taking this medication. It may be best to learn how to monitor your own blood pressure and pulse. Discuss this with your doctor. MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip