Alteplase

By

Generic Name: Alteplase Brand Name(s): Generics only. No brands available.

Uses

What is alteplase used for?

Alteplase is commonly used to treat blood clots. It may be given to you for other reasons. Talk with the doctor.

How should I take alteplase?

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

It is given as a shot into the catheter.

How do I store alteplase?

Alteplase is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store alteplase in the bathroom or the freezer. There may be different brands of alteplase that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush alteplase down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using alteplase?

Before using this drug, tell your doctor if:

  • You are pregnant or breastfeeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.
  • You are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
  • You have allergy with any of active or inactive ingredients of alteplase or other medications.
  • You have any other illnesses, disorders, or medical conditions.

Tell all of your health care providers that you take alteplase. This includes your doctors, nurses, pharmacists, and dentists.

You may bleed more easily. Be careful and avoid injury. Use a soft toothbrush and an electric razor.

Use care to prevent injury and avoid falls or crashes.

Have blood work checked as you have been told by the doctor. Talk with the doctor.

If you are 75 or older, use this medicine with care. You could have more side effects.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using alteplase during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking alteplase. Alteplase is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from alteplase?

Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Signs of bleeding like throwing up blood or throw up that looks like coffee grounds; coughing up blood; blood in the urine; black, red, or tarry stools; bleeding from the gums; vaginal bleeding that is not normal; bruises without a reason or that get bigger; or any bleeding that is very bad or that you cannot stop.
  • Redness, swelling, or pain at the catheter site.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with alteplase?

Alteplase may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with alteplase?

Alteplase may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with alteplase?

Alteplase may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using alteplase.

What is the dose of alteplase for an adult?

Usual Adult Dose for Myocardial Infarction

For accelerated infusion method:

  • Over 67 kg: 100 mg administered as a 15 mg IV bolus followed by 50 mg infused over the next 30 minutes and then 35 mg infused over the next 60 minutes.
  • 67 or less kg: 15 mg IV bolus, followed by 0.75 mg/kg (not to exceed 50 mg) infused over the next 30 minutes and then 0.5 mg/kg (not to exceed 35 mg) infused over the next 60 minutes.

For 3-hour infusion method:

  • Over 65 kg: 100 mg administered as 60 mg IV in the first hour (with 6 to 10 mg of it given as an IV bolus over 1 to 2 minutes), followed by 20 mg/hour IV during hours 2 and 3.
  • Less than 65 kg: 1.25 mg/kg administered as 0.75 mg/kg IV in the first hour (with 6 to 10 mg of it given as an IV bolus over 1 to 2 minutes), followed by 0.25 mg/kg/hour during hours 2 and 3. Heparin is usually given during and following administration of alteplase. Aspirin and/or dipyridamole have been given during and/or following heparin treatment.

Usual Adult Dose for Pulmonary Embolism

50 mg/hour IV over 2 hours for a total dose of 100 mg. Heparin is usually started near the end or immediately following this infusion when partial thromboplastin time or thrombin time falls to twice the normal value or less.

Usual Adult Dose for Ischemic Stroke

0.9 mg/kg (up to 90 mg) IV over 60 minutes with 10% of the total dose administered as an initial IV bolus over the first minute.

Usual Adult Dose for Thrombotic/Thromboembolic Disorder

Occluded central venous catheter:

Manufacturer’s recommendations (CathFlo Activase): Patients 30 or more kg: 2 mg in 2 mL; may instill second dose if catheter remains occluded after 2-hour dwell time. A recent study using escalating doses of 0.5 mg, 1 mg, and 2 mg (60-minute dwell time) found that 86.2% of catheters were cleared with the 0.5 mg dose.

What is the dose of alteplase for a child?

Usual Pediatric Dose for Thrombotic/Thromboembolic Disorder

Occluded IV catheter: Infuse in to catheter, do not infuse in to patient: Dose listed is per lumen; for multilumen catheters, treat one lumen at a time; dose should always be aspirated out of catheter after dwell.

Manufacturer’s recommendations (CathFlo Activase):

  • Central venous catheter: post-natal age 14 days or older: Use a 1 mg/mL concentration; instill a volume equal to 110% of the internal lumen volume of the catheter; do not exceed 2 mg in 2 mL; leave in lumen for up to 2 hours, then aspirate out of catheter; may instill a second dose if catheter remains occluded after 2-hour dwell time.

Alternative dosing:

  • Central venous catheter: 0.5 mg diluted in NS to a volume equal to the internal volume of the lumen; instill in each lumen over 1-2 minutes; leave in lumen for 1 to 2 hours, then aspirate out of catheter; flush catheter with NS.
  • Central venous catheter: 0.25 to 0.5 mg/mL solution; instill a volume to fill the catheter; leave in lumen for up to 2 hours, then aspirate out of catheter.

How is alteplase available?

Alteplase is available in the following dosage forms and strengths:

  • Injection

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of alteplase, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Review Date: September 29, 2017 | Last Modified: September 29, 2017

Sources
You might also like