So what’s the big deal you ask? Well, it doesn’t work. This is a medical fact, because it has been studied extensively. Using oral terbutaline is no more effective than placebo at stopping preterm labor. In fact, the American Congress of Obstetricians and Gynecologists states that using oral terbutaline should not be “undertaken as a general practice.” And trust me, they are a conservative bunch. If they say don’t do something they have mulled over it for a good, long time.
But what if your friend took terbutaline and she swears it stopped her labor?
Well, not all preterm contractions are labor, and not everyone with preterm labor delivers prematurely. So some women will simply stop on their own. Studies tell us that terbutaline is simply not any better than doing nothing. So, if you know someone who swears their labor stopped because of terbutaline, there is high quality medical evidence to say it would have stopped anyway.
Terbutaline is also not risk free. It can have dangerous effects on the heart and at least 16 mothers have died as a result of the drug.
Terbutaline now has a black box warning highlighting these risks. The FDA says that injectable terbutaline to prevent preterm labor (given in the hospital) should not be used for more than 48 to 72 hours because of the risk for maternal heart problems and death. (I say it shouldn’t be used at all, because indomethacin is a better tocolytic).
In addition, oral terbutaline at home should not be used AT ALL for the prevention or treatment of preterm labor as it has the same risks as the injectable form and is ineffective.
The truth is (whether they are willing to admit it, or not) many OB/GYNs prescribe terbutaline because they want to do something/feel helpless/hope the mother will feel better because she is doing something/think maybe it reduces contractions so they will get less calls (it doesn’t). All of these are the wrong reasons to prescribe a medication.
If your doctor recommends terbutaline, I would probably start looking for another doctor. My concern? If he/she is recommending one therapy that not only doesn’t work, but is potentially harmful, what other recommendations might be not only woefully out of date, but potentially harmful?
Remember, this blog is not individual medical advice.