Myocardial ischaemia with beta-agonists

Evidence from post-marketing data and published literature suggest that myocardial ischaemia is associated with the use of short-acting beta-agonists.

In respiratory use, patients with a history of heart disease, including angina or rhythm disturbance, should be advised to continue treatment with short-acting beta-agonists, but to seek advice if symptoms such as shortness of breath or chest pain occur.

In women with significant risk factors for — or 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 (e.g. 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

Further information: MHRA

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