A 70-year old woman with acute asthma was prescribed both oral and intravenous Bricanyl (terbutalin

Fråga: A 70-year old woman with acute asthma was prescribed both oral and intravenous Bricanyl (terbutaline). She got a temporary blurred vision after intravenous administration of the drug. Is there any connection between the vision disorder and Bricanyl?

Sammanfattning: Based on retrieved information terbutaline-induced vision disorder can not be excluded.

Svar: Terbutaline has been used for about 20 years in the treatment of asthma. No case report concerning vision disorder which might be induced by terbutaline has been found in the medical literature. The beta-receptors of the eye play an important role for dilatation and adaptation for the vision of distant objects (1).

Three cases of terbutaline-associated vision disorders that occurred during treatment of asthma have been reported to the adverse drug reaction register in Sweden (2). One case described a patient who had sensations from the centre of the visual field. In the second case the patient was unable to read as the letters seemed to float together. This did only occur during treatment with terbutaline and disappeared after discontinuation. When the drug was tried anew the same visual disorders reappeared (3). The evaluation of these case reports indicated that the correlation between the side effect and terbutaline could not be excluded or was probable, respectively. In the third case where mydriasis was reported, the side effect was judged to be related to the drug.

In the WHO register on adverse drug reactions there are totally 11 cases reported on visual abnormalities of terbutaline up to 1988 (2).

We recommend this case to be reported to the committee of adverse drug reactions. 1 Goodman and Gilman, The pharmacological basis of therapeutics. 1985; 7th ed: 72 2 Swedis 3 Personligt meddelande Bengt Lindeskog, Läkemedelsverket