Terbutaline inhaler and nebuliser solution

About terbutaline

Terbutaline is prescribed as a rescue treatment for sudden breathlessness or wheezing in people with asthma or chronic obstructive pulmonary disease (COPD). It is referred to as a 'reliever' because it relieves the symptoms of breathlessness.

Terbutaline belongs to a group of medicines called bronchodilators because it widens (dilates) your airways. It works by opening up the air passages in your lungs so that air can flow into your lungs more freely. This helps to ease symptoms such as coughing, wheezing and feeling breathless. It starts to work within a few minutes and the effect will last up to six hours.

Terbutaline can also be taken as a tablet or syrup. There is a separate medicine leaflet called Terbutaline tablets and syrup which gives more information about this.

Before using terbutaline

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using terbutaline it is important that your doctor knows:

• If you are pregnant, trying for a baby or breastfeeding. This is because it is particularly important that your breathing is well controlled if you are pregnant.

• If you have heart or blood vessel problems, or if you have an irregular heartbeat.

• If you have high blood pressure.

• If you have an overactive thyroid gland.

• If you have diabetes (diabetes mellitus).

• If you have been told by a doctor that you have low levels of potassium in your blood.

• If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines. Also, please make sure that the doctor prescribing this for you knows about any other inhalers you are using.

• If you have ever had an allergic reaction to a medicine.

How to use terbutaline

• Before you use terbutaline, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about the medicine, and diagrams to remind you how to use and clean your inhaler device; it will also provide you with a full list of the side-effects which you could experience from using it.

• Follow your doctor's instructions carefully and make sure you know how to use your inhaler device properly. Ask your nurse, doctor or pharmacist to show you again if you are unsure.

• As a guide, the dose commonly prescribed for adults is one dose (one puff or one single-dose respule) when needed for breathlessness, up to a maximum of four times a day. Your dose (or your child's dose) may be different to this, and if so, it is important that you follow the directions given to you by your doctor. If you have been prescribed respules for your child, make sure that you know what volume of liquid from the respule to use in the nebuliser, and how much sterile sodium chloride 0.9% solution to dilute it with.

• If you do not get relief from your symptoms after using terbutaline, contact your doctor straightaway.

Instructions for using Bricanyl® respules

1. Break off a respule from the strip. Hold it upright and twist off the wing tab to open it up.

2. Place the open end inside the nebuliser cup and squeeze out the liquid slowly. Replace the top on the nebuliser cup.

3. Connect the top end of the cup to the face mask or mouthpiece and the bottom end to the air pump. The air pump should be connected to the compressor unit.

4. Turn on the nebuliser and breathe in the mist calmly and deeply using the face mask or mouthpiece. If you are using a face mask, make sure the face mask fits tightly.

5. The length of time it takes to nebulise all the liquid will vary with the type of equipment you use. You will know when your treatment is complete because the fine mist will stop coming out of your mask or mouthpiece.

6. Wash the nebuliser cup and mouthpiece (or face mask) in warm soapy water and rinse it out well after each use. Dry these parts by turning on the compressor and allowing air to blow through them.

Getting the most from your treatment

• Try to keep your regular appointments with your doctor and clinic. This is so your doctor can review your condition on a regular basis.

• If you have asthma, you will receive a written asthma action plan from your nurse or doctor which will help you to manage your asthma and tell you what to do if you have an asthma attack. It will tell you how many puffs (inhalations) to use for each dose, and the maximum number of inhalations you should use in 24 hours.

• Make sure that you keep your terbutaline inhaler with you all the time in case you need to use it. It should provide you with several hours' relief. If at any time you feel it is not working, you should let your asthma nurse/doctor know straightaway.

• If you are using other inhalers at the same time, use the terbutaline inhaler first and then wait for a few minutes before using the other inhalers. Terbutaline opens your air passages to allow the other inhalers to work more effectively.

• If you have also been prescribed a preventer (steroid) inhaler, you should use the preventer inhaler regularly, even if your breathing is good. Your doctor will tell you when (or if) it is appropriate for you to 'step down' your treatment.

• If at any time your breathing gets worse, continue to use your inhalers but also contact your doctor or nurse for advice straightaway. Also, if you are needing to use the maximum number of terbutaline puffs every day (or if your usual dose of terbutaline does not provide relief from your symptoms for at least three hours), you must let your doctor know about this too, as you may require additional treatment.

• Do not smoke. Smoking causes irritation and damage to the lungs and will make your condition worse. Speak with your doctor or practice nurse for further advice if you are having difficulty in stopping smoking.

• If you have diabetes you may need to check your blood glucose more frequently, as terbutaline can affect the levels of sugar in your blood. Your doctor will advise you about this.

Can inhaled terbutaline cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with terbutaline. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to terbutaline, please speak with your doctor or pharmacist for further advice.

How to store terbutaline

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines