Terbutaline use while Breastfeeding

Drugs containing Terbutaline: Brethine, Bricanyl, Brethaire

Terbutaline Levels and Effects while Breastfeeding

Summary of Use during Lactation

Maternal use of oral or inhaled terbutaline is unlikely to affect a breastfed infant. The authors of several reviews and an expert panel agree that use of inhaled bronchodilators is acceptable during breastfeeding because of the low bioavailability and maternal serum levels after use.[1][2][3][4][5]

Drug Levels

Maternal Levels. 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.[6][7][8]

Infant Levels. 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.[7][8]

Effects in Breastfed Infants

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.[6][7] These cases were also summarized in a third publication.[8]

Effects on Lactation and Breastmilk

Relevant published information was not found as of the revision date.

References

1. McDonald CF, Burdon JGW. Asthma in pregnancy and lactation. A position paper for the Thoracic Society of Australia and New Zealand. Med J Aust. 1996;165:485-8.

2. Ellsworth A. Pharmacotherapy of asthma while breastfeeding. J Hum Lact. 1994;10:39-41. PMID: 7619245

3. Nelson-Piercy C. Asthma in pregnancy. Thorax. 2001;56:325-8. PMID: 11254828

4. Taddio A, Ito S. Drugs and breast-feeding. In, Koren G, ed. Maternal-fetal toxicology. A clinician's guide. 3rd ed. New York. Marcel Dekker. 2001;177-32.

5. National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. NAEPP expert panel report. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. 2004;1-57. http://www.nhlbi.nih.gov/health/prof/lung/asthma/astpreg.htm

6. Boreus LO, de Chateau P, Lindberg C et al. Terbutaline in breast milk. Br J Clin Pharmacol. 1982;13:731-2. Letter. PMID: 7082542

7. Lonnerholm G, Lindstrom B. Terbutaline excretion into breast milk. Br J Clin Pharmacol. 1982;13:729-30. Letter. PMID: 7082541

8. Lindberg C, Boreus LO, de Chateau P et al. Transfer of terbutaline into breast milk. Eur J Resp Dis. 1984;65 (Suppl 134):87-91. PMID: 6586490

Terbutaline Identification

Substance Name

Terbutaline

CAS Registry Number

23031-25-6

Drug Class

Bronchodilators

Beta Adrenergic Agonists

Administrative Information

LactMed Record Number

251

Last Revision Date

20130907

Disclaimer

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.

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