Drug Class Description
Fibrinolytics.

Generic Name
Alteplase

Drug Description
Powder in vial plus diluent.

Presentation
Powder for injection, alteplase 10 mg , 20 mg , 50 mg .

Indications
Acute myocardial infarction; acute pulmonary embolism.

Adult Dosage
Total dose of 100 mg intravenously over three hours. MI: administer over 90 minutes if within 6 hours of symptom onset, over 3 hours if 6 - 12 hours. PE: administer over 2 hours. See Summary of Product Characteristics.

Child Dosage
Not recommended.

Contra Indications
Situations where there is a high risk of haemorrhage such as: bleeding diathesis, within 10 bleeding diathesis, within 10 days of haemorrhage or surgery, active peptic ulceration, acute pancreatitis, bacterial endocarditis, severe liver disease; history of stroke or CNS damage; severe controlled hypertension.

Special Precautions
Situations where risk of bleeding is increased. Pregnancy. Elderly. Actilyse should be given only by physicians experienced in the use of thrombolytics and with the facilities to monitor it.

Interactions
Anticoagulants.

Adverse Reactions
Bleeding is the most frequent adverse reaction. This may be superficial bleeding from punctures or damaged blood vessels, or internal bleeding into the urogenital tract, retroperitoneum or CNS or bleeding of parenchymatous organs. Intracranial haemorrhage. Cholesterol crystal embolisation or thrombotic embolisation rarely. Arrhythmias associated with reperfusion may occur. Nausea, vomiting, hypotension and fever may occur rarely.

Manufacturer
Boehringer Ingelheim

Drug Availability
(POM)