alteplase (TPA, Activase, Cathflo Activase)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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What is alteplase (TPA, Activase, Cathflo Activase)?

Alteplase is an injectable drug, given directly into a vein, that is used to treat conditions caused by arterial blood clots including heart attacks, strokes, chest pain at rest (unstable angina), blood clots in the lungs (pulmonary thrombosis or embolus), and other less common conditions involving blood clots.

What brand names are available for alteplase?

TPA, Activase, and Cathflo Activase are brand names available for alteplase.

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Heart Disease: Symptoms, Signs, and Causes

Is alteplase (TPA, Activase, Cathflo Activase) available as a generic drug?

No

Do I need a prescription for alteplase (TPA, Activase, Cathflo Activase)?

Yes

Why is alteplase (TPA, Activase, Cathflo Activase) prescribed to patients?

  • Alteplase is used to treat persons with heart attacks (acute myocardial infarctions), strokes, chest pain at rest (unstable angina), blood clots in the lungs (pulmonary thrombosis or embolism), and other less common conditions involving blood clots.
  • It also is used for clearing blood clots from blocked venous catheters.

What are the side effects of alteplase (TPA, Activase, Cathflo Activase)?

The most common and serious side effect of alteplase is bleeding. Minor bleeding is more common, but significant bleeding such as into the brain (intracranial hemorrhage) or fatal bleeding also occurs.

Other important side effects include:

Other possible serious side effects include:

Quick GuideHeart Disease: Symptoms, Signs, and Causes

Heart Disease: Symptoms, Signs, and Causes

What is the dosage for alteplase (TPA, Activase, Cathflo Activase)?

  • Clogged catheter: Alteplase is injected intravenously or directly into a clogged catheter.
  • Heart attack: For heart attacks the recommended dose is a 15 mg injection followed by 50 mg or 0.75 mg/kg (up to 50 mg) infused over 30 minutes then 35 mg or 0.5 mg/kg (up to 35 mg) over 60 minutes. The total dose is 100 mg. It also can be infused over 3 hours.
  • Pulmonary embolism: The dose for treating pulmonary embolism is 100 mg infused over 2 hours.
  • Stroke: The dose for treating acute ischemic stroke is 0.9 mg/kg infused over one hour not to exceed 90 mg. Clogged catheters are cleared by injecting 2 mg/2 ml solution into the clogged catheter.

Which drugs or supplements interact with alteplase (TPA, Activase, Cathflo Activase)?

Alteplase breaks down clots and thereby interferes with the body's ability to stop bleeding. Therefore, drugs which also interfere with the body's ability to form blood clots (or the clot-promoting effects of platelets) increase the risk of bleeding in patients receiving alteplase. Such drugs include

Is alteplase (TPA, Activase, Cathflo Activase) safe to use during pregnancy or while breastfeeding?

  • Alteplase has been shown to cause damage to embryos of rabbits. No damage has been reported in humans. Doctors must carefully balance potential risks and possible benefits when prescribing alteplase to pregnant women.
  • It is not known whether alteplase passes into breast milk.

What else should I know about alteplase (TPA, Activase, Cathflo Activase)?

What preparations of alteplase (TPA, Activase, Cathflo Activase) are available?

Powder is mixed with sterile water for injection: 2, 50, and 100 mg vials.

How should I keep alteplase (TPA, Activase, Cathflo Activase) stored?
  • The vials are stored at room temperature up to 80 F (30 C) or under refrigeration at 2-8 C (36-46 F).
  • Once mixed with sterile water, it must be used immediately.
  • Any drug not used must be thrown away.
How does alteplase (TPA, Activase, Cathflo Activase) work?
  • Alteplase is an enzyme that occurs naturally in man and causes blood clots to dissolve. It is a man-made protein manufactured by recombinant DNA technology. The naturally occurring protein, known as tissue plasminogen activator (TPA), is made by ovarian cells from the Chinese hamster. The amount that is given to patients is far greater than the amount naturally made by the body itself.
When was alteplase (TPA, Activase, Cathflo Activase) approved by the FDA?
  • Alteplase was first approved for heart attacks in 1987. In 1996, it was approved for strokes.

Reference: FDA Prescribing Information

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See more info: alteplase on RxList
Reviewed on 11/3/2016
References
Reference: FDA Prescribing Information

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