title: Clinical issues surrounding the use of terbutaline sulfate for preterm labor.
abstract: beta-mimetics have been prescribed by physicians to arrest or prevent premature labor for more than 20 years. Although not approved by the Food and Drug Administration (FDA) for tocolytic use, terbutaline sulfate has been the most widely prescribed beta-mimetic in the United States. Recently, the role of terbutaline in the treatment and prevention of preterm labor has been questioned by the FDA. Because the off-label use of drugs is a formally accepted practice in medicine when scientific studies support such use, we reviewed the currently available clinical literature on terbutaline use in various routes of delivery: intravenous, oral, and subcutaneous via infusion pump. This review describes the clinical evidence that supports the safe and effective use of terbutaline as a tocolytic agent in certain patient populations. Practicing physicians should continue to have unrestricted use of terbutaline for tocolysis as one of the few remaining therapeutic options remaining in the fight against preterm birth.
authors.affiliation: California-Pacific Medical Center, San Francisco, USA.
authors.forename: F
authors.initials: F
authors.lastname: Lam
authors.forename: J
authors.initials: J
authors.lastname: Elliott
authors.forename: J S
authors.initials: JS
authors.lastname: Jones
authors.forename: M
authors.initials: M
authors.lastname: Katz
authors.forename: R A
authors.initials: RA
authors.lastname: Knuppel
authors.forename: J
authors.initials: J
authors.lastname: Morrison
authors.forename: R
authors.initials: R
authors.lastname: Newman
authors.forename: J
authors.initials: J
authors.lastname: Phelan
authors.forename: R
authors.initials: R
authors.lastname: Willcourt
mesh_terms: D000284:Administration, Oral; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017277:Drug Approval; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D013726:Terbutaline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015149:Tocolytic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000318:Adrenergic beta-Agonists; D015149:Tocolytic Agents; D013726:Terbutaline