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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. </p></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK501107_"><span class="title" itemprop="name">Terbutaline</span></h1><p class="small">Last Revision: <span itemprop="dateModified">July 15, 2024</span>.</p><p><em>Estimated reading time: 2 minutes</em></p></div><div class="body-content whole_rhythm" itemprop="text"><p>CASRN: 23031-25-6</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134993786" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134993786" alt="image 134993786 in the ncbi pubchem database" /></a><div id="LM251.Drug_Levels_and_Effects"><h2 id="_LM251_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM251.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Maternal use of oral or inhaled terbutaline is unlikely to affect a breastfed infant. The authors of several reviews and expert guidelines agree that use of inhaled bronchodilators is acceptable during breastfeeding because of the low bioavailability and maternal serum levels after use.[<a class="bk_pop" href="#LM251.REF.1">1</a>-<a class="bk_pop" href="#LM251.REF.4">4</a>] Terbutaline use as a tocolytic agent might decrease the duration of breastfeeding.</p></div><div id="LM251.Drug_Levels"><h3>Drug Levels</h3><p><i>Maternal Levels.</i> With long-term maternal intake of 2.5 or 5 mg three times daily orally, milk terbutaline levels ranged from 2.5 to 4 mcg/L at various times during the dosing interval. There was little fluctuation of milk levels. The average dose that an exclusively breastfed infant would receive based on these patients is 1.4% (range 0.7 to 2.2%) of the maternal weight-adjusted dose.[<a class="bk_pop" href="#LM251.REF.5">5</a>-<a class="bk_pop" href="#LM251.REF.7">7</a>]</p><p><i>Infant Levels.</i> Serum levels were undetectable (<0.1 mcg/L) in one 8-week-old exclusively breastfed infant whose mother was taking oral terbutaline 5 mg three times daily.[<a class="bk_pop" href="#LM251.REF.5">5</a>,<a class="bk_pop" href="#LM251.REF.7">7</a>]</p></div><div id="LM251.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Two papers have reported a total of 4 infants aged 3 to 8 weeks who were breastfed during maternal use of oral terbutaline 2.5 or 5 mg three times daily. None of the infants had any signs of sympathetic stimulation and all were developing normally.[<a class="bk_pop" href="#LM251.REF.6">6</a>,<a class="bk_pop" href="#LM251.REF.7">7</a>] These cases were also summarized in a third publication.[<a class="bk_pop" href="#LM251.REF.5">5</a>]</p></div><div id="LM251.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>A small retrospective survey from Serbia found that mothers who received a beta agonist pharmacologically similar to terbutaline (fenoterol or hexoprenaline) as a tocolytic breastfed for a shorter period of time than those who received no tocolytic (4.5 vs 9.5 months).[<a class="bk_pop" href="#LM251.REF.8">8</a>] It is not known if terbutaline has a similar effect.</p><p>A study in an Australian hospital compared breastfeeding outcomes in women who received a cesarean section during 2 time periods. During the first time period women did not receive terbutaline before a category one or two cesarean section (n = 423). In the second period, all women receiving a category one or two cesarean section received terbutaline 250 mcg subcutaneously as a tocolytic agent unless there was a contraindication at the time a decision was made to perform a cesarean section (n = 253). The breastfeeding rates at the time of discharge were 95% in the first period and 99% in the second period. The difference was statistically significant.[<a class="bk_pop" href="#LM251.REF.9">9</a>]</p></div><div id="LM251.References"><h3>References</h3><dl class="temp-labeled-list"><dt>1.</dt><dd><div class="bk_ref" id="LM251.REF.1">McDonald
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CF, Burdon
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JGW. Asthma in pregnancy and lactation. A position paper for the Thoracic Society of Australia and New Zealand.
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Med J Aust
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1996;165:485-8
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[<a href="https://pubmed.ncbi.nlm.nih.gov/8937369" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8937369</span></a>]</div></dd><dt>2.</dt><dd><div class="bk_ref" id="LM251.REF.2">Nelson-Piercy
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C.
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Asthma in pregnancy.
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Thorax
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2001;56:325-8
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[<a href="/pmc/articles/PMC1746013/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1746013</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/11254828" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11254828</span></a>]</div></dd><dt>3.</dt><dd><div class="bk_ref" id="LM251.REF.3">National Heart, Lung, and Blood, Institute, et al. NAEPP expert panel report. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. J Allergy Clin Immunol 2005;115:34-46 [<a href="https://pubmed.ncbi.nlm.nih.gov/15637545" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 15637545</span></a>]</div></dd><dt>4.</dt><dd><div class="bk_ref" id="LM251.REF.4">Bendien
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SA, de Kruif
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MD, Feitsma
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H, et al.
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Summary of the Dutch Multidisciplinary Practice Guideline on Asthma and Pregnancy.
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J Allergy Clin Immunol Pract
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2024;12:1751-62
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[<a href="https://pubmed.ncbi.nlm.nih.gov/38513758" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 38513758</span></a>]</div></dd><dt>5.</dt><dd><div class="bk_ref" id="LM251.REF.5">Lindberg
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C, Boréus
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LO, de Château
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P, et al.
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Transfer of terbutaline into breast milk.
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Eur J Respir Dis Suppl
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1984;134:87-91
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[<a href="https://pubmed.ncbi.nlm.nih.gov/6586490" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6586490</span></a>]</div></dd><dt>6.</dt><dd><div class="bk_ref" id="LM251.REF.6">Boréus
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LO, de Château
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P, Lindberg
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C, et al.
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Terbutaline in breast milk.
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Br J Clin Pharmacol
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1982;13:731-2
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[<a href="/pmc/articles/PMC1402089/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1402089</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/7082542" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7082542</span></a>]</div></dd><dt>7.</dt><dd><div class="bk_ref" id="LM251.REF.7">Lönnerholm
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G, Lindström
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B. Terbutaline excretion into breast milk.
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Br J Clin Pharmacol
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1982;13:729-30
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[<a href="/pmc/articles/PMC1402083/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1402083</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/7082541" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7082541</span></a>]</div></dd><dt>8.</dt><dd><div class="bk_ref" id="LM251.REF.8">Bjelakovic
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L, Trajkovic
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T, Kocic
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G, et al.
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The association of prenatal tocolysis and breastfeeding duration.
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Breastfeed Med
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2016;11:561-3
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[<a href="https://pubmed.ncbi.nlm.nih.gov/27704871" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27704871</span></a>]</div></dd><dt>9.</dt><dd><div class="bk_ref" id="LM251.REF.9">Buckley
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VA, Wu
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J, De Vries
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B. Outcomes following acute tocolysis prior to emergency caesarean section.
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Aust N Z J Obstet Gynaecol
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2020;60:884-9
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[<a href="https://pubmed.ncbi.nlm.nih.gov/32378185" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32378185</span></a>]</div></dd></dl></div></div><div id="LM251.Substance_Identification"><h2 id="_LM251_Substance_Identification_">Substance Identification</h2><div id="LM251.Substance_Name"><h3>Substance Name</h3><p>Terbutaline</p></div><div id="LM251.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>23031-25-6</p></div><div id="LM251.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Bronchodilator Agents</p><p>Beta Adrenergic Agonists</p></div></div><div><dl class="temp-labeled-list small"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></div><div id="bk_toc_contnr"></div></div></div>
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