Common Side Effects of Terbutaline
Terbutaline commonly causes tremor, tachycardia, anxiety, palpitations, and nervousness as side effects due to its beta-adrenergic stimulating properties. 1
Primary Side Effect Profile
Terbutaline is a selective beta-2 agonist used primarily as a bronchodilator for asthma treatment. Its side effects are primarily related to its sympathomimetic activity:
Cardiovascular Effects
- Heart rate increases: Tachycardia is common and dose-dependent 1, 2
- Palpitations and chest pain 1
- Blood pressure changes: Typically increases systolic while decreasing diastolic pressure 2
- Cardiac arrhythmias in susceptible patients 1
- Myocardial ischemia (rare but serious) 1
Neurological/Musculoskeletal Effects
- Tremor: Most common side effect, dose-dependent 3
- Anxiety and nervousness 1
- Headache 4
- Dizziness 5
- Seizures (rare): Case reports exist of focal seizures in pediatric patients 5
Metabolic Effects
- Transient hyperglycemia: Blood glucose increases 2
- Hypokalemia: Due to intracellular potassium shifting 1, 6
- Potential worsening of diabetes in susceptible patients 1
Special Considerations
Pregnancy Concerns
While not directly related to the question about common side effects, it's important to note that terbutaline has serious risks when used for tocolysis (delaying preterm labor):
- Pulmonary edema (0.32% incidence) 7
- Cardiac arrhythmias 1
- Myocardial ischemia 1
- The FDA has explicitly warned against using terbutaline for tocolysis due to serious maternal and fetal risks 8
Pediatric Considerations
- In appropriate doses (2.5 mg orally for children 7-14 years weighing 25-50 kg), terbutaline has shown minimal cardiovascular side effects 9
- However, terbutaline is not recommended for patients under 12 years due to insufficient safety data 1
Drug Interactions
- Beta-blockers: Can block bronchodilator effects and potentially cause severe bronchospasm 1
- MAOIs and tricyclic antidepressants: May potentiate cardiovascular effects 6
- Non-potassium sparing diuretics: May worsen ECG changes and hypokalemia 6
Comparative Safety Profile
When administered by inhalation rather than systemically, terbutaline produces similar bronchodilation with significantly fewer systemic side effects 3, making the inhaled route preferable when possible.
The side effect profile is similar to other beta-2 agonists, though some studies report that terbutaline may cause more frequent tremor than other agents in this class 4.