Active Ingredient: Alteplase
Alteplase is indicated for the thrombolytic treatment in acute massive pulmonary embolism with haemodynamic instability. The diagnosis should be confirmed whenever possible by objective means such as pulmonary angiography or non-invasive procedures such as lung scanning. There is no evidence for positive effects on mortality and late morbidity related to pulmonary embolism.
For this indication, competent medicine agencies globally authorize below treatments:
Intravenous
100 mg
100 mg once every day
A total dose of 100 mg of alteplase should be administered in 2 hours. Most experience is available with the following dose regimen:
| Concentration of alteplase 1 mg/ml | Concentration of alteplase 2 mg/ml | |
|---|---|---|
| ml | ml | |
| 10mg as an intravenous bolus over 1-2 minutes | 10 | 5 |
| followed by an intravenous infusion of 90 mg over 2 hours | 90 | 45 |
The total dose should not exceed 1.5 mg/kg in patients with a body weight below 65 kg.
After treatment with Actilyse heparin therapy should be initiated (or resumed) when aPTT values are less than twice the upper limit of normal. The infusion should be adjusted to maintain aPTT between 50-70 seconds (1.5 to 2.5 fold of the reference value).
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