Dosage and administration
Use in bronchospasm :Â Terbutaline tablets and syrup have a duration of action of 7 to 8 hours. The minimum recommended dosage interval is therefore 7 hours.
Adults : Tablets :Â During the first 1-2 weeks 2.5 mg (1 tablet) 3 times in a 24 hour period is recommended. The dose may then be increased to 5 mg (2 tablets) 3 times in 24 hours to achieve adequate bronchodilation.
Syrup : The starting dose should be 2×5 ml spoonfuls (3 mg) 3 times in 24 hours. The dose may then be increased to 3×5 ml spoonfuls (4.5 mg) 3 times in 24 hours if necessary.
Elderly :Â Dosage as for adults.
Children :Â Tablets : 7-15 years, the starting dose should normally be 2.5 mg (1 tablet) 2 times in 24 hours. However, in some patients, the dose may need to be increased to 2.5 mg (1 tablet) 3 times in 24 hours.
Syrup :Â 0.25 ml (0.075 mg)/kg body weight 3 times in a 24 hour period.
Drug interactions : §-blocking agents, especially the non-selective ones such as propranolol may partially or totally inhibit the effect of §-stimulants. Therefore Terbutaline preparations and non-selective §-blockers should not normally be administered concurrently. Terbutaline should be used with caution in patients receiving other sympathomimetics.
Use in pregnancy and lactation :Â Although no teratogenic effects have been observed in animals or in patients, Terbutaline should only be administered with caution during the first trimester of pregnancy. Terbutaline is secreted via breast milk, but effect on the infant is unlikely at therapeutic doses.
Side-effects : The frequency of side-effects is low at the recommended doses. Side-effects which have been recorded such as tremor, headache, tonic cramp and palpitations are all characteristic of sympathomimetic amines. A few patients feel tense; this is also due to the effects on skeletal muscle and not to direct CNS stimulation. Whenever these side-effects have occurred the majority have usually been spontaneously reversible within the first week of treatment. Urticaria and exanthema may occur. In children sleep disturbances and disturbances of behavioural effects have been observed. Potentially serious hypokalaemia may result from §2-agonist therapy.
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