Last update Jan. 30, 2021

R03AC03; R03CC03

Compatible

Safe product and/or breastfeeding is the best option.

Short-acting beta-adrenergic bronchodilator, similar in characteristics to salbutamol.
Indicated in the treatment of asthma.
Administration preferably inhaled (also oral or intravenous).

It is excreted into breast milk in clinically non-significant amount (Lindberg 1984, Lonnerholm 1982, Boreus 1982) and neither clinical nor development problems were observed in infants whose mothers were treated with oral terbutaline (Lindberg 1984, Lonnerholm 1982, Boreus 1982) .
Plasma levels of these infants were undetectable or very low (Lindberg 1984, Lonnerholm 1982).

Preferable preparations are inhaled bronchodilators since <10% of the dose is absorbed.

Several medical societies, experts authors and expert consensus consider the use of inhaled bronchodilators to be safe during breastfeeding (Hale, Lactmed, Amir 2011, National Asthma 2004, Nelson 2001, Ellsworth 1994).
American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).

Alternatives

We do not have alternatives for R03AC03; R03CC03 since it is relatively safe.

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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José María Paricio, founder of e-lactancia.
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Other names

R03AC03; R03CC03 is Terbutaline Sulfate in ATC Code/s.

Is written in other languages:

Groups

R03AC03; R03CC03 belongs to these groups or families:

Tradenames

Main tradenames from several countries containing R03AC03; R03CC03 in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 30-50 (Inhal: 10) %
Molecular weight 549 daltons
Protein Binding 20 %
VD 1 - 2 l/Kg
pKa 8.86 -
Tmax 0.5 hours
T½ 12 hours
M/P ratio 2 - 2.9 -
Theoretical Dose 0.0005 mg/Kg/d
Relative Dose 0.2 %
Ped.Relat.Dose 0.3 %

References

  1. Bendien SA, de Kruif MD, Feitsma H, van Hoolwerff-Blikkendaal C, Huurne KK, Kuiterman A, Baranova EV, Wittkamp A, Brons A, Poulissen M, van der Meer AN. Summary of the Dutch Multidisciplinary Practice Guideline on Asthma and Pregnancy. J Allergy Clin Immunol Pract. 2024 Jul;12(7):1751-1762. Consulted on Nov. 7, 2024 Abstract
  2. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  3. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  4. Middleton PG, Gade EJ, Aguilera C, MacKillop L, Button BM, Coleman C, Johnson B, Albrechtsen C, Edenborough F, Rigau D, Gibson PG, Backer V. ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases. Eur Respir J. 2020 Feb 6;55(2). pii: 1901208. Abstract Full text (link to original source) Full text (in our servers)
  5. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract Full text (link to original source) Full text (in our servers)
  6. Nice FJ, De Eugenio D, Dimino TA, Freeny IC, Rovnack MB, Gromelski JS. Medications and Breast-Feeding: A Guide for Pharmacists, Pharmacy Technicians, and Other Healthcare Professionals. Part I. J Pharm Technol 2004;20:17-27. doi: 10.1177/875512250402000106.
  7. National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. 2004;1-57. None 2004 Full text (link to original source) Full text (in our servers)
  8. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  9. Nelson-Piercy C. Asthma in pregnancy. Thorax. 2001 Abstract Full text (link to original source) Full text (in our servers)
  10. Ellsworth A. Pharmacotherapy of asthma while breastfeeding. J Hum Lact. 1994 Abstract
  11. Hochhaus G, Möllmann H. Pharmacokinetic/pharmacodynamic characteristics of the beta-2-agonists terbutaline, salbutamol and fenoterol. Int J Clin Pharmacol Ther Toxicol. 1992 Abstract
  12. Lindberg C, Boréus LO, de Château P, Lindström B, Lönnerholm G, Nyberg L. Transfer of terbutaline into breast milk. Eur J Respir Dis Suppl. 1984 Abstract
  13. Lönnerholm G, Lindström B. Terbutaline excretion into breast milk. Br J Clin Pharmacol. 1982 Abstract Full text (link to original source) Full text (in our servers)
  14. Boréus LO, de Château PU. Terbutaline in breast milk. Br J Clin Pharmacol. 1982 Abstract Full text (link to original source) Full text (in our servers)

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