Bricanyl Special Precautions

As for all β₂-agonists caution should be observed in patients with thyrotoxicosis.
Cardiovascular effects may be seen with sympathomimetic drugs, including Terbutaline sulfate (Bricanyl). There is some evidence from post-marketing data and published literature of myocardial ischaemia associated with beta agonists.
Patients with underlying severe heart disease (e.g. ischaemic heart disease, arrhythmia or severe heart failure) who are receiving Terbutaline sulfate (Bricanyl) should be warned to seek medical advice if they experience chest pain or other symptoms of worsening heart disease.
Attention should be paid to assessment of symptoms such as dyspnoea and chest pain, as they may be of either respiratory or cardiac origin.
Due to the hyperglycemic effects of β₂-agonists, additional blood glucose controls are recommended initially in diabetic patients.
Potentially serious hypokalemia may result from β₂-agonist therapy. Particular caution is recommended in acute severe asthma as the associated risk may be augmented by hypoxia. The hypokalemic effect may be potentiated by concomitant treatments (see Interactions). It is recommended that serum potassium levels are monitored in such situations.
Patients with persistent asthma who require maintenance therapy with β₂-agonists should also receive optimal anti-inflammatory therapy, e.g., inhaled corticosteroids, leukotriene receptor antagonists. These patients must be advised to continue taking their anti-inflammatory therapy after the introduction of Terbutaline sulfate (Bricanyl) even when symptoms decrease. Should symptoms persist, or if treatment with β₂-agonists needs to be increased, this indicates a worsening of the underlying condition and warrants a reassessment of the therapy.
Effects on ability to drive and use machines: Terbutaline sulfate (Bricanyl) does not affect the ability to drive or use machines.