Rheotromb
Rheotromb Uses, Dosage, Side Effects, Food Interaction and all others data.
Rheotromb is used for the treatment of pulmonary embolisms. The low molecular weight form of human urokinase consists of an A chain of 2,000 daltons linked by a sulfhydryl bond to a B chain of 30,400 daltons. Rheotromb is an enzyme (protein) produced by the kidney, and found in the urine. There are two forms of urokinase which differ in molecular weight but have similar clinical effects. Rheotromb is the low molecular weight form. Rheotromb acts on the endogenous fibrinolytic system. It converts plasminogen to the enzyme plasmin. Plasmin degrades fibrin clots as well as fibrinogen and some other plasma proteins.
Rheotromb acts on the endogenous fibrinolytic system. It cleaves the Arg-Val bond in plasminogen to produce active plasmin. Plasmin degrades fibrin clots as well as fibrinogen and other plasma proteins.
Rheotromb is a serine protease that activates plasminogen to an active fibrinolytic protease. The duration of action is short due to the short half life. Patients should be counselled regarding the risk of bleeding, anaphylaxis, infusion reactions, and cholesterol embolization.[L12138
| Trade Name | Rheotromb |
| Availability | Prescription only |
| Generic | Urokinase |
| Urokinase Other Names | Kinase (enzyme-activating), uro-urokinase, TCUK, Tissue culture urokinase, Two-chain urokinase, Urochinasi, Urokinase, Urokinasum, Uroquinasa |
| Related Drugs | aspirin, lisinopril, metoprolol, propranolol, Xarelto, Eliquis, warfarin, Plavix, Brilinta, enoxaparin |
| Type | |
| Formula | C1376H2145N383O406S18 |
| Weight | 31126.5 Da |
| Protein binding | Data regarding the protein binding of urokinase in plasma is not readily available. |
| Groups | Approved, Investigational, Withdrawn |
| Therapeutic Class | Fibrinolytics (Thrombolytics) |
| Manufacturer | |
| Available Country | Hungary |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Rheotromb injection is used for adults:
- For the lysis of acute massive pulmonary emboli, defined as obstruction of blood flow to a lobe or multiple segments.
- For the lysis of pulmonary emboli accompanied by unstable hemodynamics, i.e., failure to maintain blood pressure without supportive measures.
The diagnosis should be confirmed by objective means, such as pulmonary angiography or noninvasive procedures such as lung scanning.
Rheotromb is also used to associated treatment for these conditions: Acute massive pulmonary embolism, Obstruction; Catheter, Infusion Catheter (Vascular), Pulmonary Embolism, Thromboembolism of the Coronary Artery, Thromboembolism of the Graft, Thromboembolism of the Peripheral Artery
How Rheotromb works
Rheotromb is a serine protease. It cleaves plasminogen to form the active fibrinolytic protease, plasmin.
Dosage
Rheotromb dosage
Deep vein thrombosis: Initial loading dose of 4,400 IU/kg in 15 mL soln over 10 min, followed by 4,400 IU/kg/hr IV infusion for 12-24 hr.
Pulmonary embolism: Initial loading dose of 4,400 IU/kg in 15 mL soln over 10 min followed by 4,400 IU/kg/hr IV infusion for 12 hr.
Peripheral vascular occlusion: Infuse 2,500 IU/mL (500,000 IU in 200 mL) into clot at a rate of 4,000 IU/min for 2 hr.
Advance the catheter into the remaining occluded area & infuse at 4,000 IU/min for another 2 hr. This may be repeated up to 4 times.
Hyphaema: 5,000 IU in 2 mL saline soln is injected and withdrawn repeatedly over the iris. If residual clot remains, leave 0.3 mL in the anterior chamber for 24-48 hr to facilitate further dissolution.
Clotted arterio-venous shunts: Instill 5,000-25,000 IU into affected shunt limb & clamp for 2-4 hr, followed by aspiration of lysate. Repeat if necessary.
Side Effects
Overt bleeding, haemorrhagic complications, fever, haematuria, initial severe pain & dull ache in shunt limb.
Toxicity
Patients experiencing an overdose may present with bleeding. Treat patients with symptomatic and supportive measures which may include application of local pressure, administration of whole blood or plasma, and administration of aminocaproic acid.
Precaution
GI lesions & in multiple intracardiac or intravascular punctures as a consequence of cardiopulmonary resuscitation
Interaction
Concomitant use of oral anticoagulant or heparin & drugs that affect platelet function may increase risk of haemorrhage.
Food Interaction
- Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.
Rheotromb 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
Rheotromb Drug Interaction
Moderate: aspirinUnknown: spironolactone, sulfamethoxazole / trimethoprim, ubiquinone, copper gluconate, phenytoin, glycerin, sodium iodide, arginine, insulin isophane, acetaminophen, bioflavonoids, hydrocortisone, diazepam, valproic acid, thiamine, cyanocobalamin, pyridoxine, cholecalciferol, phytonadione
Rheotromb Disease Interaction
Volume of Distribution
The volume of distribution of urokinase is 11.5L.
Elimination Route
Rheotromb is delivered intravenously, so the bioavailability is high.
Half Life
Rheotromb has a half life of 12.6±6.2 minutes.
Clearance
Data regarding the clearance of urokinase is not readily available.
Elimination Route
Rheotromb is eliminated in the bile and urine.
Pregnancy & Breastfeeding use
Pregnancy Category B. Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1sttrimester (and there is no evidence of a risk in later trimesters).
Contraindication
Recent surgery or biopsy, severe HTN, severe hepatic or renal insufficiency. Pregnancy & immediate postpartum period.
Acute Overdose
If severe haemorrhage occurs, treatment with Rheotromb-GCC must be stopped. Aprotinin and synthetic inhibitors eg, epsilon aminocaproic acid, tranexamic acid or p-aminomethylbenzoic acid can be used to inhibit the fibrinolytic action of Rheotromb-GCC. In serious cases, human fibrinogen, Factor XIII, Cohn-Fraction I, packed red cells or whole blood can be given, as appropriate.
Innovators Monograph
You find simplified version here Rheotromb
FAQ
What is Rheotromb used for?
Rheotromb is used to treat blood clots in the lungs. Rheotromb may also be used for purposes not listed in this medication guide.
How does Rheotromb work?
Rheotromb directly cleaves plasminogen to produce plasmin. When it is purified from human urine, approximately 1500 L of urine is needed to yield enough urokinase to treat a single patient.
What is the side effect of Rheotromb?
Rheotromb increases your risk of bleeding, which can be severe or life-threatening.other common side effects are include:
Is Rheotromb safe during pregnancy?
Rheotromb should not be given during pregnancy or in the immediate postpartum unless it is clearly needed.
Is Rheotromb safe during breastfeeding?
Breastfeeding should be avoided during use of this drug.
How is Rheotromb given?
Rheotromb is injected into a vein through an IV. A healthcare provider will give you this injection.
Rheotromb is given slowly, usually over a period of 12 hours, using a continuous infusion pump.
Is Rheotromb a thrombolytic?
Rheotromb is a physiologic thrombolytic agent that is produced in renal parenchymal cells.
What happens if I overdose?
Since this Rheotromb is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid while receiving Rheotromb?
Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
How is Rheotromb obtained?
Rheotromb which is produced by kidney cells and can be recovered from urine. It directly activates plasminogen and is now manufactured with use of recombinant DNA technology.
Is Rheotromb made from urine?
Rheotromb is an endogenous activator, which is produced by kidney cells and can be recovered from urine.
