Alteplase
Known brand names include Activase.
A clot-dissolving drug (tPA) given by IV in the hospital. It treats acute ischemic stroke, heart attack, and massive clots in the lungs, and its main danger is bleeding.
Known brand names include Activase.
A clot-dissolving drug (tPA) given by IV in the hospital. It treats acute ischemic stroke, heart attack, and massive clots in the lungs, and its main danger is bleeding.
Alteplase is a lab-made copy of tissue plasminogen activator, an enzyme the body uses to break down clots. It sticks to fibrin, the protein mesh that holds a clot together. Once attached, it turns plasminogen trapped in the clot into plasmin, which digests the fibrin and breaks the clot apart. Because it works mainly where fibrin is present, it causes only limited clot breakdown elsewhere in the blood.
It is cleared from the blood quickly, mostly by the liver, with an early half-life of under 5 minutes. It is usually given as a quick starting push into the vein followed by a drip lasting up to 3 hours, depending on the condition. Because it breaks down clots, its main risk is serious and sometimes fatal bleeding, inside the body or from needle sites, including bleeding in the brain. It also lowers the level of fibrinogen, a clotting protein, in the blood.
Alteplase, also called tPA, is a drug that dissolves blood clots that have formed inside blood vessels. It treats acute ischemic stroke, a stroke in which a clot cuts off blood flow to part of the brain. In a heart attack, it is used to lower the chance of dying and of developing heart failure. It also breaks up a massive pulmonary embolism, a clot in the lungs big enough to block a whole lobe or to make blood pressure hard to keep up.
It is given into a vein by a hospital team, usually as one treatment started as soon as possible after symptoms begin. For stroke, it must be started within 3 hours of the first symptoms, and only after bleeding in the brain has been ruled out as the cause. Stroke treatment belongs in hospitals that can quickly find and manage bleeding in the brain. Its safety in children has not been established, and in heart attacks with a low risk of death, the added stroke risk may outweigh the benefit.
Bleeding is the most common problem, from needle and IV sites, the gut, the urinary tract, the nose, or the gums, along with bruising. The label treats bleeding in the brain as the most serious risk, especially after stroke treatment, and also warns of severe allergic reactions, including swelling of the face, lips, and throat that is more likely in people taking ACE inhibitors. Other serious problems include new clots breaking loose from the heart or leg veins and, rarely, bits of cholesterol plaque that block blood flow to the toes, kidneys, or other organs.