Alteplase, under the brand name Activase, received FDA approval on November 10, 1987, for treating acute myocardial infarction (heart attack).

Alteplase is used to dissolve blood clots and restore blood flow in conditions such as acute ischemic stroke, acute myocardial infarction (heart attack), and pulmonary embolism.

Alteplase is administered intravenously (injection in a vein) under medical supervision. Your healthcare professional will determine the specific dosage and administration guidelines based on your condition and needs.

Alteplase may cause several side effects, the most significant being an increased risk of bleeding, which can lead to serious and life-threatening complications. Other common side effects include fever, headache, nausea, vomiting, and bleeding at the injection site. Serious allergic reactions and hypersensitivity may occur in some individuals.

Alteplase carries several warnings that should be considered before use. Serious allergic reactions, including anaphylaxis, can necessitate immediate medical attention if symptoms like difficulty breathing or facial swelling occur. This medication significantly increases the risk of bleeding. Serious bleeding events can occur at various sites in the body, including the brain, gastrointestinal tract, and other critical locations. It can lead to bleeding in the brain, resulting in a condition called intracranial hemorrhage. This is a severe and potentially life-threatening complication.

In some cases, blood vessels may re-occlude (re-form blood clots) after initial treatment. This may necessitate additional interventions to address the recurrent clotting. It can cause a drop in blood pressure (hypotension), leading to symptoms such as dizziness, lightheadedness, or fainting.

It is essential to avoid using alteplase in patients with active bleeding or a history of recent significant bleeding events. Due to the risk, this medication is contraindicated in patients with a history of intracranial hemorrhage or known structural cerebral vascular lesions. Close monitoring of blood pressure is crucial during treatment.

Advice regarding Alteplase is to always consult with a healthcare professional before starting or making any changes to your medication regimen. Tell your doctor if you have a history of bleeding disorders, recent surgery or trauma, gastrointestinal bleeding, or other conditions that may increase bleeding risk. Close monitoring of patients is required throughout treatment to detect any bleeding or adverse reactions promptly. It should be used in a hospital setting with access to emergency facilities, and immediate medical care must be available in case of complications. Pregnancy and breastfeeding women should consult a doctor before starting treatment. Advanced age can increase the risk of bleeding complications with this medication, particularly in patients over 75. The dosage adjustment is required in elderly patients.

1. KD Tripathi, Essentials of Medical Pharmacology, Drugs affecting coagulation, bleeding and thrombosis, 7th edition, 2013, 627.
2. Boehringer Ingelheim International GmbH, European medicines compendium (emc), [Revised on April 2021] [ Accessed on 24th March 2023], https://www.medicines.org.uk/emc/files/pil.10361.pdf
3. Genentech, Inc, US Food and Drug Administration, [Revised on August 2001] [Accessed on 24th Jult 2023], https://www.accessdata.fda.gov/drugsatfda_docs/label/2001/altegen090401lb.pdf

The drug information on this page is not a substitute for medical advice, it is meant for educational purposes only. For further details, consult your doctor about your medical condition to know if you can receive this treatment.