Terbutaline

Source: Wikipedia, the free encyclopedia.
For the UK-based company, see
Marex Spectron
.
Terbutaline
Terbutaline (top),
and (R)-(−)-terbutaline (bottom)
Clinical data
AHFS/Drugs.comMonograph
MedlinePlusa682144
Pregnancy
category
  • AU: A
  • C
SQ
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
Pharmacokinetic data
Protein binding25%
MetabolismGI tract (oral), liver; CYP450: unknown
Elimination half-life11–16 hours
Excretionurine 90% (60% unchanged), bile/faeces
Identifiers
  • (RS)-5-[2-(tert-Butylamino)-1-hydroxyethyl]benzene-1,3-diol
JSmol)
ChiralityRacemic mixture
  • Oc1cc(cc(O)c1)C(O)CNC(C)(C)C
  • InChI=1S/C12H19NO3/c1-12(2,3)13-7-11(16)8-4-9(14)6-10(15)5-8/h4-6,11,13-16H,7H2,1-3H3 ☒N
  • Key:XWTYSIMOBUGWOL-UHFFFAOYSA-N ☒N
 ☒NcheckY (what is this?)  (verify)

Terbutaline, sold under the brand names Bricanyl and Marex among others, is a

preterm labor for up to 48 hours. This time can then be used to administer steroid injections to the mother which help fetal lung maturity and reduce complications of prematurity.[1] It should not be used to prevent preterm labor or delay labor more than 48–72 hours. In February 2011, the Food and Drug Administration began requiring a black box warning on the drug's label. Pregnant women should not be given injections of the drug terbutaline for the prevention of preterm labor or for long-term (beyond 48–72 hours) management of preterm labor, and should not be given oral terbutaline for any type of prevention or treatment of preterm labor "due to the potential for serious maternal heart problems and death."[2][3]

It was patented in 1966 and came into medical use in 1970.[4] It is on the World Health Organization's List of Essential Medicines.[5]

Medical uses

Terbutaline is used as a fast-acting

premature labor
.

As an asthma treatment, the inhaled form of terbutaline, starts working within 15 minutes and can last up to 6 hours. It is also sold as an injectable solution, an oral tablet, and as a syrup (in combination with guaifenesin).

Terbutaline is a pregnancy category C medication and is prescribed to stop contractions. After successful intravenous tocolysis, little evidence exists that oral terbutaline is effective.[7] Terbutaline as a treatment for premature labor is an off-label use not approved by the US FDA, who have warned that oral terbutaline is not effective and can cause severe heart problems or death, and while injectable terbutaline can be used for premature labor in emergency situations in a hospital setting, it should only be used for short periods of time.[8]

Side effects

Pharmacology

The tertiary butyl group in terbutaline makes it more selective for

catechol-O-methyl transferase.[11]

Chemistry

Terbutaline is synthesized by brominating 3,5-dibenzyloxy

Pd/C leads to terbutaline.[12][13][14]

Stereochemistry

Terbutaline contains a stereocenter and consists of two enantiomers. This is a

racemate, ie a 1: 1 mixture of (R) - and the (S) - form:[15]

Enantiomers of terbutaline

(R)-Terbutaline
(S)-Terbutaline

Society and culture

Athletics

As with all β2-adrenergic receptor agonists, terbutaline is on the World Anti-Doping Agency's list of prohibited drugs, except when administered by inhalation and a Therapeutic Use Exemption (TUE) has been obtained in advance.

Brand names

Brand names include Bronclyn, Brethine, Bricanyl, Brethaire, Marex, and Terbulin.

References

  1. ^ WHO. "Antenatal administration of corticosteroids for women at risk of preterm birth". WHO. Archived from the original on July 24, 2009. Retrieved 2013-03-25.
  2. ^ "Most Popular E-mail Newsletter". USA Today. 18 February 2011.[permanent dead link]
  3. ^ "FDA warns against certain uses of asthma drug terbutaline for preterm labor". Food and Drug Administration. Archived from the original on 2015-09-21. Retrieved 2015-09-13.
  4. ISBN 9783527607495
    .
  5. hdl:10665/345533
    . WHO/MHP/HPS/EML/2021.02.
  6. S2CID 20258298
    .
  7. PMID 12423870. Archived from the original
    on 2011-07-20.
  8. ^ "FDA Drug Safety Communication: New warnings against use of terbutaline to treat preterm labor". Center for Drug Evaluation and Research. FDA. 17 February 2011. Retrieved 11 May 2021.
  9. ISBN 978-1-59541-101-3
    .
  10. ^ "Terbutaline: Drug information". Original Source: UpToDate. Archived from the original on 2013-06-28. Retrieved 2021-11-25 – via 5 Minute Consult.
  11. ^ Mehta A (1992). Melloni B, Germouty J (eds.). "Medicinal Chemistry of the Peripheral Nervous System–Adrenergics and Cholinergics their Biosynthesis, Metabolism, and Structure Activity Relationships". PharmaXChange. pp. 503–507. Archived from the original on 2010-11-04.
  12. ^ GB 1199630, "Phenylethanolamine Derivatives Effective in the Treatment of Bronchospastic Conditions", issued 1967, assigned to Draco Lunds Farmacevtiska Aktiebolag 
  13. ^ BE 704932, "1-3,5-dihydroxyphenyl-2-alkylaminoethanols", issued 1968, assigned to Draco Lunds Farmacevtiska Aktiebolag 
  14. ^ US 3937838, Svensson LA, Wetterlin ID, "Orally Active Bronchospasmolytic Compounds and Their Preparation", issued 1976 
  15. ISBN 978-3-642-63389-8
    .
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