Systemic administration in acute transmural MI not >12 hr w/ persistent ST-segment elevation or recent left bundle-branch block, DVT not >14 days, acute massive pulmonary embolism, acute & subacute peripheral arteries thromboses, chronic occlusive arterial diseases not >6 wk, central retinal artery or vein occlusion (arterial occlusions not >6-8 hr, venous occlusions not >10 days). Local administration in acute MI for re-opening of coronary vessels not >12 hr, acute, subacute & chronic thromboses as well as peripheral venous & arterial vessel embolisms.
Short-term lysis for acute MISystemic 1,500,000 IU w/in 60 min. Local 20,000 IU intracoronary bolus. Maintenance: 2,000-4,000 IU/min over 30-90 min. Short-term thrombolysis adult w/ peripheral venous & arterial vessel occlusions/embolismsSystemic Initially 250,000 IU w/in 30 min, followed by maintenance: 1,500,000 IU/hr over max: 6 hr. Long-term lysis for peripheral occlusions Initially 250,000 IU w/in 30 min, followed by maintenance: 100,000 IU/hr. Max duration: 5 days. Acute, subacute & chronic peripheral thromboses & embolismsLocal 1,000-2,000 IU in 3-5 min intervals up to 3 hr at total max dose: 120,000 IU. Central retinal vessels thrombosesSystemic Max duration of therapy: 24 hr for arterial occlusion; 72 hr for venous occlusion. Interrupt therapy for 1 day, followed by homologous fibrinolytic administration if continuation of thrombolysis is indicated due to extensive thrombotic occlusions.
Hypersensitivity. Existing or recent internal haemorrhage; all forms of reduced blood coagulability, in particular spontaneous fibrinolysis & extensive clotting disorders; recent CVA, intracranial or intraspinal surgery; intracranial neoplasm; recent head trauma; arteriovenous malformation or aneurysm; known neoplasm w/ risk of haemorrhage; acute pancreatitis; uncontrollable HTN w/ systolic values >200 mmHg &/or diastolic values >100 mmHg or hypertensive retinal changes grades III/IV; recent vessel prosthesis implantation; simultaneous or recent treatment w/ oral anticoagulants (INR >1.3); endocarditis or pericarditis; known haemorrhagic diathesis; recent major op (6th-10th post-op day, depending on extent of the procedure); invasive op eg, recent organ biopsy, long-term (traumatic) closed chest cardiac massage. Severe hepatic or renal damage.
Not indicated for patency restoration of IV catheters. Severe bleeding eg, intracranial haemorrhage; procedures & management of arterial/venous puncture; recent severe GI bleeding eg, active peptic ulcer; risk of severe local haemorrhage eg, in case of translumbar aortography; recent trauma & cardiopulmonary resuscitation; invasive op eg, recent intubation; puncture of non-compressible vessels, IM inj, large arteries; urogenital tract diseases w/ existing or potential bleeding sources (implanted bladder catheter); known septic thrombotic disease; severe arteriosclerotic vessel degeneration, cerebrovascular diseases; cavernous pulmonary diseases eg, open TB or severe bronchitis; mitral valve defects or atrial fibrillation; aortic dissection; diabetic retinopathy. Recent streptococcal infections eg, streptococcal pharyngitis, acute rheumatic fever & glomerulonephritis. Antistreptokinase Ab development; pre-treatment w/ heparin or coumarin derivatives. Perform mandatory & frequent haematological tests eg, blood coagulation tests. Administer corticosteroids prophylactically to reduce infusion-related allergic reactions. Recent abortion or delivery. Not to be used during pregnancy. Lactation. Elderly.
Increased risk of haemorrhage w/ anticoagulants eg, heparin or drugs inhibiting platelet formation or function eg, platelet aggregation inhibitors, dextrans.
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 1_500_000 IU069baf9f-d48c-4c95-aea3-aec8009017d6.GIF)
