TOCOLYTICS

TERBUTALINE
Indication: Acute bronchospasm, severe bronchospasm, uncomplicated
premature labor
Contraindication: if parenteral, prolonged (beyond 48-72 hr) or
maintenance tocolysis, particularly in outpatient or home setting. PO: Acute
or maintenance tocolysis.
Dosing:
Inhalation/Respiratory for Acute bronchospasm
Adult: As metered-dose powd inhaler: 250-500 mcg as required. Max: 2,000
mcg daily.
Inhalation/Respiratory for Severe bronchospasm
Adult: As 1% nebulizer solution: 2.5-10 mg 2-4 times daily.
Intravenous for Uncomplicated premature labor
Adult: To arrest labour between 22-37 wk of gestation: Initially, 5 mcg/min,
w/ increments of 2.5 mcg/min at 20 min intervals until contractions stop.
Max: 20 mcg/min. Continue for 1 hr after contractions have ceased, then
decrease by 2.5 mcg/min every 20 min to lowest dose that maintains
suppression. Max duration: 48 hr.
Oral for Acute bronchospasm
Adult: Initially, 2.5 mg or 3 mg tid, up to 5 mg tid as necessary. As modifiedrelease tab: 5 mg or 7.5 mg bid.
Parenteral for Severe bronchospasm
Adult: 250-500 mcg up to 4 times daily by SC, IM or IV inj, or by IV infusion
as a soln containing 3-5 mcg/mL at a rate of 0.5-1 mL/min.
Brands available in the Philippines:
Bricalin
Bricanyl
Bronchodam
Pulmoxcel

ISOXUPRINE
Indication: arrest premature labor

Contraindication: Recent arterial hemorrhage. Do not give immediately

postpartum and do not use in premature labor if there is an infection.
Dosing: Parenteral to Arrest premature labor
Adult: 200-500 mcg/minute as IV infusion; adjust according to response until
control is achieved. Monitor maternal BP and hydration, maternal and foetal
heart rates during the infusion. Once labour has been arrested, administer 10
mg every 3-8 hr for several days via IM inj. May continue prophylaxis orally
by giving 30-90 mg daily in divided doses.
Brands available in the Philippines:

Duvacare
Duvagen
Duvaprine
Isoxilan
Suprinex
Uteprine
Duvadilan

MAGNESIUM SULFATE
Indication: Eclampsia, Preterm Labor (Off-label use)
Contraindication: Parenteral: Heart block, severe renal impairment,
myocardial damage.
Dosing:
For Preterm Labor
Loading dose: 4-6 g IV over 20 minutes; maintenance: 2-4 g/hr IV for 12-24
hours as tolerated after contractions cease
Do not exceed 5-7 days of continuous treatment; longer treatment duration
may lead to hypocalcemia in developing fetus resulting in neonates with
skeletal abnormalities related to osteopenia

For eclampsia

Adult: Typical loading dose: 4-5 g over 10-15 minutes, followed by either a
continuous infusion of 1 g/hr (for at least 24 hr after the last seizure) or deep
IM doses of 4-5 g into alternate buttocks every 4 hr (for at least 24 hr after
the last seizure). If seizure recurs, an additional IV dose of 2-4 g may be

given. Continue therapy until paroxysms cease. A serum magnesium level of

6 mg/100 mL is considered optimal for seizure control. Not to exceed 30-40 g
per 24 hr

Brands available in the Philippines:

Epsom salt
Euromed Magnesium sulfate
Elin Magnesium sulfate
Phil Pharmawealth/ Atlantic Magnesium sulfate