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Beta-2 Agonist — Acute Tocolysis

Terbutaline (Acute Tocolysis / Fetal Bradycardia)

Brand names: Bricanyl

Terbutaline is a short-acting beta-2 adrenergic agonist used in obstetrics for acute, short-term uterine relaxation (tocolysis), for example to manage uterine hyperstimulation with fetal compromise or to facilitate intrapartum procedures.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It stimulates myometrial beta-2 adrenoceptors, raising intracellular cyclic AMP and relaxing uterine smooth muscle to reduce contraction frequency and intensity.

Prescribing in practice

  • It can cause significant maternal tachycardia, arrhythmia, hypotension, hyperglycaemia, and pulmonary oedema, so it is reserved for short-term use with maternal cardiovascular monitoring and is contraindicated in significant cardiac disease.
  • It is used for acute, short-term tocolysis only and not for prolonged maintenance of pregnancy.
  • It crosses the placenta and may cause transient fetal and neonatal tachycardia and hypoglycaemia.

Monitoring

Monitor maternal heart rate, blood pressure, and symptoms (chest pain, breathlessness) during administration, alongside the fetal heart rate.

Counselling the patient

  • Explain that this medicine is given to relax the womb briefly and help the baby.
  • A faster heartbeat and tremor are expected short-lived effects.
  • Tell the team immediately about chest pain or breathlessness.

Evidence & guidelines

Acute beta-agonist tocolysis to relieve uterine hyperstimulation is established obstetric practice consistent with current prescribing references.

Reference: MHRA Drug Safety Update 2011 (terbutaline tocolysis); RCOG Green-top 1b (Tocolysis); ALSO Advanced Life Support in Obstetrics; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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