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Brethine (Generic Terbutaline)

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Terbutaline is a medication primarily used to treat asthma and chronic obstructive pulmonary disease (COPD) by opening up the airways in the lungs. While it can be effective, there are potential risks associated with its use. Some of these risks include:

  • Cardiovascular effects: Terbutaline can cause an increase in heart rate (tachycardia) and palpitations. In some cases, it may lead to irregular heart rhythms (arrhythmias), chest pain, and high blood pressure.
  • Tremors and nervous system effects: It may cause tremors, nervousness, anxiety, headache, dizziness, and insomnia.
  • Hypokalemia: Terbutaline can lower potassium levels in the blood, leading to weakness, muscle cramps, and in severe cases, abnormal heart rhythms.
  • Hyperglycemia: In some individuals, terbutaline can increase blood sugar levels, which may be of concern for people with diabetes.
  • Respiratory effects: Paradoxically, in rare cases, terbutaline can cause bronchospasm, worsening breathing difficulties.
  • Potential for abuse: Terbutaline has been misused as a tocolytic agent to delay preterm labor, which can lead to serious maternal and fetal complications if not used appropriately.

It’s important for individuals using terbutaline to be aware of these potential risks and to use the medication as prescribed by their healthcare provider. Regular monitoring and communication with a healthcare professional can help mitigate these risks and ensure safe and effective use of the medication.

Why is this medication prescribed?

Terbutaline is prescribed primarily for the treatment of asthma and chronic obstructive pulmonary disease (COPD). It belongs to a class of medications known as beta-2 adrenergic agonists, which work by relaxing the muscles in the airways, making breathing easier.

How should this medicine be used?

Terbutaline comes as a tablet to take by mouth. Terbutaline tablets may be prescribed for certain conditions such as asthma or premature labor. The dosage and frequency will be determined by the healthcare provider based on the individual’s medical condition and response to treatment.

It’s important for patients to follow their healthcare provider’s instructions carefully when using Terbutaline. They should not exceed the recommended dosage or frequency of use unless instructed to do so by their healthcare provider. If symptoms worsen or if the medication does not seem to be providing adequate relief, patients should seek medical advice promptly.

Additionally, Terbutaline should not be used as a rescue medication for sudden asthma attacks. Patients should have a separate short-acting beta agonist inhaler (such as albuterol) for immediate relief of asthma symptoms. Terbutaline is typically used for long-term management and prevention of symptoms.

Other uses for this medicine

Terbutaline, besides its primary use in treating asthma and COPD, has other off-label uses, including:

  • Preterm Labor: Terbutaline may be prescribed to delay premature labor by relaxing the uterine muscles. However, its use for this purpose is considered off-label and should only be done under close medical supervision due to potential risks to both the mother and the fetus.
  • Hyperkalemia Treatment: In some cases, Terbutaline is used to treat hyperkalemia (high levels of potassium in the blood) by shifting potassium from the bloodstream into the cells.

What special precautions should I follow?

Special precautions should be observed when using Terbutaline. Here are some important points to consider:

  • Medical History: Patients should inform their healthcare provider of their medical history, especially if they have a history of heart problems, high blood pressure, diabetes, thyroid disorders, seizures, or any other medical conditions.
  • Pregnancy and Breastfeeding: Pregnant or breastfeeding individuals should discuss the risks and benefits of Terbutaline with their healthcare provider. Its use during pregnancy should be limited to situations where the potential benefits outweigh the risks.
  • Allergies: Patients should inform their healthcare provider of any allergies to Terbutaline or other medications.
  • Drug Interactions: Terbutaline may interact with other medications, including beta blockers, monoamine oxidase inhibitors (MAOIs), and diuretics. Patients should inform their healthcare provider of all medications, supplements, and herbal products they are taking to avoid potential interactions.
  • Monitoring: Regular monitoring of heart rate, blood pressure, potassium levels, and glucose levels may be necessary during treatment with Terbutaline, especially in individuals with pre-existing medical conditions.
  • Avoiding Overuse: Terbutaline should not be used more frequently or at higher doses than prescribed. Overuse can lead to adverse effects and may indicate poorly controlled asthma or COPD.
  • Emergency Use: Patients should have a rescue inhaler containing a short-acting beta agonist (such as albuterol) for sudden asthma attacks. Terbutaline is not intended for immediate relief of acute symptoms.
  • Quitting Smoking: Patients with asthma or COPD should be advised to quit smoking, as smoking can worsen respiratory symptoms and decrease the effectiveness of medications like Terbutaline.

It’s crucial for patients to discuss any concerns or questions about Terbutaline with their healthcare provider to ensure safe and effective use.

What special dietary instructions should I follow?

Special dietary instructions for Terbutaline are generally not required. However, it’s essential to maintain a healthy diet as recommended by your healthcare provider, especially if you have conditions like diabetes or high blood pressure.

What should I do if I forget a dose?

If you forget to take a dose of Terbutaline, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for the missed one. If you are unsure about what to do, contact your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Terbutaline, like any medication, can cause side effects. Common side effects of Terbutaline may include:

  • Tremors: Shaking or trembling of the hands or other parts of the body.
  • Nervousness or Anxiety: Feeling jittery or anxious.
  • Headache: Mild to moderate headaches may occur.
  • Dizziness: Feeling lightheaded or dizzy.
  • Palpitations: Awareness of the heartbeat, which may feel rapid, irregular, or pounding.
  • Increased Heart Rate: Tachycardia, or a faster than normal heartbeat.
  • Muscle Cramps: Unpleasant, involuntary muscle contractions.
  • Insomnia: Difficulty falling asleep or staying asleep.
  • Nausea or Vomiting: Some individuals may experience gastrointestinal discomfort.
  • Hyperglycemia: Elevated blood sugar levels, which may be of concern for people with diabetes.
  • Hypokalemia: Low potassium levels in the blood, which can lead to weakness, muscle cramps, and in severe cases, abnormal heart rhythms.
  • Bronchospasm: In rare cases, Terbutaline can paradoxically cause bronchospasm, worsening breathing difficulties.
  • Allergic Reactions: Serious allergic reactions to Terbutaline are rare but possible. Seek immediate medical attention if you experience symptoms such as rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing.

It’s essential to report any unusual or persistent side effects to your healthcare provider. They can help determine whether the benefits of Terbutaline outweigh its potential risks and may adjust your treatment accordingly.

What should I know about storage and disposal of this medication?

Here’s what you should know about the storage and disposal of Terbutaline:


  • Store Terbutaline at room temperature, away from moisture and heat.
  • Keep the medication in its original container with the lid tightly closed.
  • Store Terbutaline out of reach of children and pets, as it can be harmful if ingested.


  • Dispose of any unused or expired Terbutaline tablets properly according to local regulations or guidelines.
  • Do not flush Terbutaline down the toilet or pour it down the drain unless instructed to do so by a healthcare professional or pharmacist.
  • Check with your pharmacist or local waste disposal facility for instructions on how to properly dispose of Terbutaline.

In case of emergency/overdose

  • If you suspect an overdose or experience severe symptoms such as chest pain, irregular heartbeats, seizures, or difficulty breathing after taking Terbutaline, seek emergency medical attention immediately.
  • Contact your local poison control center (in the US, call 1-800-222-1222) for guidance on what to do next.
  • Be prepared to provide information about the amount of Terbutaline ingested, the time of ingestion, and any symptoms experienced.

What other information should I know?

  • Inform healthcare providers, including dentists and emergency medical personnel, that you are taking Terbutaline before undergoing any medical procedures or emergency treatment.
  • Avoid excessive use of Terbutaline, as it may lead to tolerance and decreased effectiveness over time.
  • Keep track of your medication supply and refill it as needed to ensure continuous treatment.
  • Attend regular medical appointments for monitoring of your condition and response to Terbutaline therapy.
  • Do not share Terbutaline with others, even if they have similar symptoms, as it may not be safe or appropriate for them.

Following these guidelines can help ensure safe and effective use of Terbutaline while minimizing the risk of adverse effects and complications.

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