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Home › Articles › Medications and Herbs › Talking Terbutaline

Talking Terbutaline

Preterm Labor Drug Causes Controversy

By Teri Brown

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According to Dr. Fink, there have been concerns about the safety of prolonged use of terbutaline. The drug does cross the placenta, meaning it enters the baby's circulation. There are controversial studies showing that the drug may be associated with an increased risk of brain hemorrhage in the preemie, one of the potential complications of prematurity anyway.

"There are problems with the way these studies were conducted, and no large, well-controlled prospective trials have been undertaken," Dr. Fink says. "Also, prolonged use of terbutaline results in a 'wearing down' of the effectiveness over time, and is also associated with some not-insignificant side effects in Mom."

These side affects may include jitteriness, increased heart rate, tremors, headaches, dizziness and, very rarely, increased blood sugar and seizures.

The Controversy
The controversy concerning terbutaline stems from the FDA and the lack of controlled studies concerning terbutaline.

The FDA sent out a letter in 1997 warning about the use of terbutaline and especially use of the pump used to give a measured dose of terbutaline. In conclusion, it stated, "In the absence of data establishing the effectiveness and safety of the drug/device, FDA is alerting practitioners, home health care agencies, insurance carriers and others that continuous subcutaneous administration of terbutaline sulfate has not been demonstrated to be effective and is potentially dangerous."

Dr. John Elliott, a perinatologist and the medical director of Maternal/Fetal Medicine at Banner Good Samaritan Hospital in Phoenix, Ariz., has studied and treated preterm labor for years and has developed a national reputation for care and management of women delivering high-order multiple births (triplets or more). He disagrees with the FDA conclusions and uses terbutaline quite regularly with his patients who warrant it.


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