Bricanyl Turbohaler

Bricanyl contains terbutaline sulphate, a selective beta-2 adrenergic agonist that provides rapid relief of reversible airway obstruction.

It is prescribed for acute bronchospasm in asthma, COPD, and other conditions characterised by airways narrowing.

Terbutaline relaxes bronchial smooth muscle by activating beta-2 receptors, leading to bronchodilation within five minutes of inhalation.

The Turbuhaler device delivers a dry-powder formulation that does not require coordination between actuation and inhalation, making it suitable for patients who struggle with pressurised metered-dose inhalers.

Clinical Role

Bricanyl is a reliever medication. Like salbutamol, it does not address the inflammatory component of asthma, and most patients require a preventer inhaler alongside it.

Frequent use — more than two to three times per week — warrants a clinical review to ensure preventer therapy is optimised.

Bricanyl Turbuhaler is also used in obstetrics as a tocolytic to delay premature labour, though this indication is managed exclusively in hospital settings under close monitoring.

Using the Turbuhaler

Unscrew and remove the white cover. Hold the inhaler upright and twist the coloured grip fully in one direction, then back until you hear a click. This loads the dose.

Breathe out gently, away from the mouthpiece. Place your lips around the mouthpiece and breathe in forcefully and deeply. Hold your breath for about ten seconds.

Do not shake the Turbuhaler. It is a dry-powder device and does not need shaking. When the red indicator reaches the bottom of the window, approximately 20 doses remain.

General Advice

Carry Bricanyl with you at all times. Rinse your mouth with water if throat irritation occurs. Clean the outside of the mouthpiece weekly with a dry cloth.

Adults

• Turbuhaler: 0.5 mg (one inhalation) as needed; may repeat once. Maximum 6 inhalations in 24 hours.
• Oral tablets: 2.5-5 mg three times daily

Children (5-12 years)

• Turbuhaler: 0.5 mg as needed; maximum 4 inhalations in 24 hours

Children Under 5

• Oral syrup as directed by the prescriber; Turbuhaler is not suitable under age 5

If you regularly need more than 2 doses per day, your maintenance therapy should be reassessed.

Common (up to 1 in 10 patients)

• Tremor, particularly of the hands
• Headache
• Tachycardia and palpitations
• Muscle cramps

Uncommon (up to 1 in 100 patients)

• Restlessness or nervousness
• Dizziness
• Throat irritation from the dry powder

Rare (up to 1 in 1,000 patients)

• Hypokalaemia (low potassium), especially at high doses
• Cardiac arrhythmias
• Paradoxical bronchospasm — discontinue and seek medical attention

Very Rare (fewer than 1 in 10,000 patients)

• Urticaria and angioedema
• Sleep disturbance in children

Tremor and tachycardia are dose-dependent and usually diminish within a few days of regular use.

Asthma Monitoring

Escalating reliever use indicates deteriorating control. If Bricanyl is needed on most days, your doctor should review your preventer regimen.

Overuse without adequate anti-inflammatory therapy increases the risk of a serious attack.

Cardiovascular Caution

Use with care in patients with ischaemic heart disease, tachyarrhythmias, or hypertrophic obstructive cardiomyopathy. Report unexplained chest pain or palpitations.

Metabolic Effects

High-dose terbutaline may lower serum potassium and raise blood glucose. Potassium monitoring is advisable during acute nebulised treatment, particularly alongside corticosteroids or diuretics.

Pregnancy

Inhaled terbutaline at standard doses is considered compatible with pregnancy. Uncontrolled asthma is more dangerous to the pregnancy than the medication.

Do not use Bricanyl if you have a known hypersensitivity to terbutaline sulphate or lactose (Turbuhaler contains lactose monohydrate as a carrier).

Not recommended as sole therapy for asthma without a concomitant preventer. Exercise caution in thyrotoxicosis, severe cardiovascular disease, and phaeochromocytoma.