Short-acting beta-agonists are indicated for reversible airway obstruction, or prevention of premature labour, or both. Short-acting beta-agonists are available as inhalation, oral, intravenous, or subcutaneous preparations.

Cardiovascular effects might occur with any sympathomimetic drug, including short-acting beta-agonists. There is some evidence from post-marketing data and published literature of myocardial ischaemia associated with use of short-acting beta-agonists.

Obstetric use

In women with significant risk factors for, or women who have pre-existing, ischaemic heart disease the risk of myocardial ischaemia outweighs the benefits of use of short-acting beta-agonists such as Ritodrine, Salbutamol, or Terbutaline for the prevention of premature labour.
Other treatments ( eg, Atosiban ) do not carry a similar risk.

In all other patients, short-acting beta-agonists should be used with caution in the prevention of premature labour because of the risk of myocardial ischaemia.

Attention should be given to fluid balance and monitoring of cardiorespiratory function ( ECG monitoring should be considered ). Discontinue treatment if signs of myocardial ischaemia develop during treatment with short-acting beta-agonists.

Respiratory use

Patients with a history of heart disease, including angina or rhythm disturbance, should be advised to continue treatment with short-acting ß agonists, but to seek medical advice if symptoms such as shortness of breath or chest pain occur during treatment because they may suggest worsening heart disease.

Source: MHRA – Drug Safety Update, 2007

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