How does this medication work? What will it do for me?

Terbutaline belongs to the class of medications called bronchodilators. It helps to open airways and make breathing easier. Terbutaline works by relaxing the muscles of the airways (lungs) to quickly relieve the symptoms of asthma, chronic bronchitis, and emphysema. This medication usually works within 5 minutes to make breathing easier.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each Turbuhaler contains 120 doses of micronized terbutaline sulfate. Each inhalation from the multiple-dose powder inhaler contains 0.5 mg of terbutaline sulfate. Nonmedicinal ingredients: lactose.

How should I use this medication?

The usual recommended adult dose of terbutaline is one inhalation when required.  This is usually adequate to relieve symptoms. However, if a second dose is needed, it should be taken preferably 5 minutes after the first dose. If a second dose does not make it easier for you to breathe, seek immediate medical help.

The effects of this medication should last 4 to 7 hours. If a previously effective dose fails to provide the usual relief, or if the effects of a dose last less than 3 hours, contact a doctor immediately, as this is a sign that your condition is getting worse. If you need to use terbutaline every day to relieve symptoms, consult your doctor. You should not need more than 6 inhalations in a 24-hour period.

Follow the package instructions carefully for proper use of your inhalation device. It is important to breathe in through your mouth forcefully and deeply. The amount of medication dispensed from the inhaler is very small, so you may not be able to taste the powder after inhalation. However, you can still be confident that the dose has been inhaled if you have followed the package instructions. Avoid exhaling into the inhalation device and always put the cover back on after use.

A small amount of this medication may be left in the mouth after inhaling a dose. To decrease the risk of side effects, rinse your mouth with water after using the inhaler.

The terbutaline inhaler has a dose counter that slowly moves down with each dose that is taken. Every 20th dose is marked with a number and every 10th dose is marked on the counter with a dash. When the counter background turns red there are approximately 10 doses left. When the “0” on the background has been reached you should start a new inhaler. Clean the outside of the mouthpiece once a week with a dry tissue. Never use water or any other fluid. If fluid enters the inhaler, it may not work properly.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to use this medication exactly as prescribed by your doctor. Do not take more than prescribed without consulting your doctor. This medication is usually used only when required to relieve symptoms.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to terbutaline or any ingredients of this medication
  • are allergic to other sympathomimetic amines (e.g., salbutamol, formoterol)
  • are allergic to lactose
  • are using this medication to prevent premature labour or threatened abortion
  • have abnormal heart rhythms associated with fast heart rate

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • dizziness
  • drowsiness
  • flushing
  • headache
  • hyperactivity
  • increased heart rate
  • muscle cramps
  • nausea
  • nervousness
  • rash
  • shakiness
  • sweating
  • tremor
  • trouble sleeping
  • upset stomach
  • vomiting
  • weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • agitation
  • chest pain
  • heart palpitations (irregular or fast heartbeat, usually felt as a rapid thumping in the chest)
  • restlessness
  • signs of low potassium levels in the blood (e.g., weakness, fatigue, muscle cramps, irregular heartbeat)

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • bronchospasm – difficulty breathing immediately after using the medication
  • symptoms of a serious allergic reaction, e.g.:
    • difficulty breathing
    • hives
    • swelling of the face or throat

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Appropriate use of the medication: Terbutaline should not be used on a regular daily basis without appropriate regular daily use of an inhaled anti-inflammatory medication (e.g., budesonide, beclomethasone, ciclesonide, fluticasone).

Blood Pressure: This medication can cause increased blood pressure. If you have high blood pressure or are at risk of developing high blood pressure, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Diabetes: Terbutaline may cause an increase in blood sugar levels (may cause a loss of blood glucose control) and glucose tolerance may change. People with diabetes may find it necessary to monitor their blood sugar more frequently while using this medication.

If you have diabetes or are at risk for developing diabetes, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Heart rhythm: Beta-agonists such as terbutaline can cause changes to the normal rhythm of the heart. If you are at risk for heart rhythm problems (e.g., people with heart failure, angina, low potassium or magnesium levels), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Inhalation-induced bronchospasm: Inhaled forms of medications may cause spasms of the airways, which make breathing difficult. If you experience this problem when using terbutaline, stop using this medication immediately. Speak to your doctor if you experience any problems with breathing while taking this or other inhaled medication.

Low blood potassium: Terbutaline can cause low potassium levels in the blood. If you experience weakness, tiredness, muscle cramps, nausea, or vomiting while receiving this medication, let your doctor know. Your doctor will monitor your potassium levels with blood tests if needed.

Proper use of device: To ensure you receive the proper dosage from your inhaler, ask your doctor, pharmacist, or other health professional to instruct you on its use.

Seizures: If you have a history of epilepsy or medical conditions that increase the risk of seizures, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Thyroid disease: People with an overactive thyroid gland may be more sensitive to the effects of terbutaline. If you have thyroid disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Worsening of symptoms: If your symptoms don't improve or seem to get worse, check with your doctor. You may need a new plan for treatment. Contact a doctor immediately if you have acute or suddenly worsening shortness of breath. Increasing use of this medication to control symptoms, especially on a regular basis or in high amounts, indicates a worsening of asthma control. Under these conditions, your treatment plan needs to be changed. It is not enough simply to increase the use of terbutaline under these circumstances, particularly over extended periods of time.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking terbutaline, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 6 years of age.

What other drugs could interact with this medication?

There may be an interaction between terbutaline and any of the following:

  • alfuzosin
  • atomoxetine
  • amiodarone
  • amphetamines (e.g., dextroamphetamine, lisdexamfetamine)
  • antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
  • atomoxetine
  • beta-blocker medications (e.g., bisoprolol, propranolol, metoprolol)
  • betahistine
  • caffeine
  • cannabis
  • decongestant cold medications (e.g., phenylephrine, pseudoephedrine)
  • decongestant eye drops and nose sprays (e.g., naphazoline, oxymetazoline, xylometazoline)
  • dexmethylphenidate
  • diabetes medications (e.g., acarbose, canagliflozin, glyburide, insulin, linagliptin, lixisenatide, metformin,  rosiglitazone, sitagliptin)
  • disopyramide
  • diuretics (e.g., bumetanide, furosemide, hydrochlorothiazide, metolazone)
  • dronedarone
  • epinephrine
  • linezolid
  • long-acting bronchodilators (e.g., formoterol, salmeterol)
  • methadone
  • methylene blue
  • methylphenidate
  • modafinil
  • monoamine oxidase inhibitors (MAO inhibitors; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
  • nabilone
  • other fast-acting bronchodilators (e.g., indacaterol, salbutamol)
  • ozanimod
  • procainamide
  • quinidine
  • quinine
  • sotalol
  • theophyllines (e.g., aminophylline, oxtriphylline, theophylline)
  • tricyclic antidepressants (e.g., amitriptyline, desipramine)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

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