Use in pregnancy: Pregnancy Category A: No teratogenic effects have been observed in animals or in patients. However, caution is recommended during the 1st trimester of pregnancy.
Oral β2 agonists with slow release must be used with caution in the final stage of pregnancy because of the tocolytic effect.
During pregnancy, serious adverse reactions, including death, have been reported after administration of terbutaline sufate to pregnant women. In the mother, these adverse reactions include increased heart rate, transient hyperglycaemia, hypokalaemia, cardiac arrhythmias, pulmonary edema, and myocardial ischaemia. Increased fetal heart rate and neonatal hypoglycaemia may occur as a result of maternal administration.
Use in lactation: Terbutaline passes over to breast milk but an influence on the child is unlikely with therapeutic doses.
Although terbutaline is secreted into breast milk, and milk concentrations are approximately those in maternal plasma, 2 individual case studies indicate that the infant is likely to receive 0.2-0.7% of the maternal dose (0.4 mcg/kg/day and 0.7 mcg/kg/day, respectively), depending (for example) on the time of feeding in relation to administration of the drug. In the 4 infants studied, this did not result in any signs of β-adrenoceptor stimulation.
Transient hypoglycaemia has been reported in newborn pre-term infants after maternal β2-agonist treatment.