Alteplase (genetical Recombination) Uses, Dosage, Side Effects and more

Alteplase (genetical Recombination) is a serine protease responsible for fibrin-enhanced conversion of plasminogen to plasmin. It produces limited conversion of plasminogen in the absence of fibrin. When introduced into the systemic circulation at pharmacologic concentration, alteplase binds to fibrin in a thrombus and converts the entrapped plasminogen to plasmin. This initiates local fibrinolysis with limited systemic proteolysis.

Pharmacodynamics: Following administration of 100 mg Alteplase (genetical Recombination), there is a decrease (16%-36%) in circulating fibrinogen. In a controlled trial, 8 of 73 patients (11%) receiving Alteplase (genetical Recombination) (1.25 mg/kg body weight over 3 hours) experienced a decrease in fibrinogen to below 100 mg/dL.

Pharmacokinetics: Alteplase (genetical Recombination) in acute myocardial infarction (AMI) patients is rapidly cleared from the plasma with an initial half-life of less than 5 minutes. There is no difference in the dominant initial plasma half-life between the 3-hour and accelerated regimens for AMI. The plasma clearance of alteplase is 380-570 mL/min, primarily mediated by the liver. The initial volume of distribution approximates plasma volume.

Trade Name Alteplase (genetical Recombination)
Availability Prescription only
Generic Alteplase
Alteplase Other Names Alteplasa, Alteplase, Alteplase (genetical recombination), Alteplase, recombinant, Alteplase,recombinant, Plasminogen activator (human tissue-type protein moiety), rt-PA, t-PA, t-plasminogen activator, Tissue plasminogen activator, Tissue plasminogen activator alteplase, Tissue plasminogen activator, recombinant, tPA
Related Drugs aspirin, lisinopril, metoprolol, propranolol, Xarelto, clopidogrel, Eliquis, warfarin, Plavix, Brilinta
Type
Formula C2569H3928N746O781S40
Weight 59042.3 Da
Groups Approved
Therapeutic Class Anti-platelet drugs, Fibrinolytics (Thrombolytics)
Manufacturer
Available Country
Last Updated: January 7, 2025 at 1:49 am

Uses

Acute Ischemic Stroke: Alteplase (genetical Recombination) is used for the treatment of acute ischemic stroke. Exclude intracranial hemorrhage as the primary cause of stroke signs and symptoms prior to initiation of treatment. Initiate treatment as soon as possible but within 3 hours after symptom onset.

Acute Myocardial Infarction: Alteplase (genetical Recombination) is used for use in acute myocardial infarction (AMI) for the reduction of mortality and the reduction of the incidence of heart failure.

Pulmonary Embolism: Alteplase (genetical Recombination) is used for the lysis of acute massive pulmonary embolism, defined as:

Alteplase (genetical Recombination) is also used to associated treatment for these conditions: Acute Ischemic Stroke (AIS), Acute Myocardial Infarction (AMI), Acute massive pulmonary embolism, Central venous access device thrombosis

How Alteplase (genetical Recombination) works

Alteplase (genetical Recombination) binds to fibrin rich clots via the fibronectin finger-like domain and the Kringle 2 domain. The protease domain then cleaves the Arg/Val bond in plasminogen to form plasmin. Plasmin in turn degrades the fibrin matrix of the thrombus, thereby exerting its thrombolytic action.

Dosage

Acute Ischemic Stroke: Administer Alteplase (genetical Recombination) as soon as possible but within 3 hours after onset of symptoms. The recommended dose is 0.9 mg/kg (not to exceed 90 mg total dose), with 10% of the total dose administered as an initial intravenous bolus over 1 minute and the remainder infused over 60 minutes. During and following Alteplase (genetical Recombination) administration for the treatment of acute ischemic stroke, frequently monitor and control blood pressure. In patients without recent use of oral anticoagulants or heparin, Alteplase (genetical Recombination) treatment can be initiated prior to the availability of coagulation study results. Discontinue Alteplase (genetical Recombination) if the pretreatment International Normalized Ratio (INR) is greater than 1.7 or the activated partial thromboplastin time (aPTT) is elevated.

Acute Myocardial Infarction: Administer Alteplase (genetical Recombination) as soon as possible after the onset of symptoms. The recommended total doses for acute myocardial infarction (AMI) is based on patient weight, not to exceed 100 mg, regardless of the selected administration regimen (accelerated or 3 hour). There are two Alteplase (genetical Recombination) dose regimens (accelerated and 3-hour) for use in the management of AMI; there are no controlled studies to compare clinical outcomes with these regimens

Pulmonary Embolism (PE): The recommended dose is 100 mg administered by IV infusion over 2 hours. Institute parenteral anticoagulation near the end of or immediately following the Alteplase (genetical Recombination) infusion when the partial thromboplastin time or thrombin time returns to twice normal or less.

Following bolus dose, if indicated:

Alteplase (genetical Recombination) is for intravenous administration only. Extravasation of Alteplase (genetical Recombination) infusion can cause ecchymosis or inflammation. If extravasation occurs, terminate the infusion at that IV site and apply local therapy. Do not add any other medication to infusion solutions containing Alteplase (genetical Recombination).

Pediatric Use: Safety and effectiveness of Alteplase (genetical Recombination) in pediatric patients have not been established.

Geriatric Use:

Side Effects

The following adverse reactions are:

Precaution

Food Interaction

Alteplase (genetical Recombination) Hypertension interaction

[Major] The use of thrombolytics is contraindicated in patients with an active bleed (internal), trauma

Risk versus benefit should be carefully considered in the following conditions and thrombolytic therapy administered with caution in patients with recent (10 days) serious GI bleed or recent (10 days) surgical procedure (coronary bypass graft, obstetrical delivery, organ biopsy, puncture of noncompressible vessel), left heart thrombus, subacute bacterial endocarditis, hemostatic defect, CV disease, diabetic hemorrhagic retinopathy, or pregnancy.

Clinical monitoring of hematopoietic, bleeding and coagulation functions is recommended prior to initiation of thrombolytic therapy.

Measures of fibrinolytic activity and

Drug Interaction

Major: heparin, heparinModerate: aspirin, aspirin, clopidogrel, clopidogrelUnknown: charcoal, charcoal, epinephrine, epinephrine, amoxicillin, amoxicillin, lorazepam, lorazepam, acetaminophen, acetaminophen, acetaminophen, acetaminophen, ondansetron, ondansetron

Disease Interaction

Major: bleeding risks

Pregnancy & Breastfeeding use

Pregnancy Category C. Alteplase (genetical Recombination) is embryocidal in rabbits when intravenously administered in doses of approximately two times (3 mg/kg) the human dose for AMI. No maternal or fetal toxicity was evident at 0.65 times (1 mg/kg) the human dose in pregnant rats and rabbits dosed during the period of organogenesis. There are no adequate and well-controlled studies in pregnant women. It is not known whether Alteplase (genetical Recombination) is excreted in human milk. Many drugs are excreted in human milk.

Storage Condition

Store lyophilized Alteplase (genetical Recombination) at controlled room temperature not to exceed 30°C, or under refrigeration (2-8°C). Protect the lyophilized material during extended storage from excessive exposure to light. If stored between 2-30°C, Alteplase (genetical Recombination) may be used within 8 hours following reconstitution. Discard any unused solution after administration is complete. Do not use beyond the expiration date stamped on the vial.

Innovators Monograph

Alteplase (genetical Recombination) contains Alteplase see full prescribing information from innovator Monograph, MSDS, FDA label

*** Taking medicines without doctor's advice can cause long-term problems.
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