An Overview of Terbutaline and Premature Labor
Terbutaline sulfate (
Brethine®) is a prescription medication used to treat
asthma and
emphysema. It is part of a group of medications called beta adrenergic agonists. Terbutaline is used "
off-label" to treat preterm labor (also known as premature labor), though it is not approved for this use.
How Terbutaline Works for Treating Preterm Labor
Terbutaline belongs to a class of drugs called beta-adrenergic receptor agonists, or beta agonists for short.
Beta agonists stimulate beta receptors in the body, including those on the muscles in the uterus. This stimulation causes the muscles to relax, which can help delay preterm labor.
There is no evidence that terbutaline can prevent premature labor that has not already started, and it usually cannot delay preterm labor for long periods. However, the medication can delay labor long enough to allow medications to be given that will help the premature infant's lungs to develop. It can also delay labor long enough to transport a pregnant woman to a facility with a neonatal intensive care unit (NICU), a hospital unit that specializes in caring for newborns.
The United States Food and Drug Administration (FDA) has recommended that a warning be added to the prescribing information for terbutaline to state that injectable terbutaline should not be used for long-term treatment (more than 48 to 72 hours) of preterm labor or for any type of prevention of preterm labor, due to the significant risks.
Similarly, the FDA also recommends that oral terbutaline (tablets) should not be used for any prevention or treatment of preterm labor at all, since it has not been shown to be effective and because of the safety concerns. Nonetheless, there may be times when a healthcare provider, together with the pregnant woman and her family, decide that long-term terbutaline treatment may be worth the risks.
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