Myocardial infarction

Active Ingredient: Reteplase

Indication for Reteplase

Population group: only adults (18 years old or older)

Reteplase is indicated for the thrombolytic treatment of suspected myocardial infarction with persistent ST elevation or recent left Bundle Branch Block within 12 hours after the onset of acute myocardial infarction AMI symptoms.

For this indication, competent medicine agencies globally authorize below treatments:

10 U (0.56 g) bolus dose followed by a second 10 U (0.56 g) bolus dose 30 minutes later (double bolus)

Route of admnistration


Defined daily dose

1.12 - 1.12 g

Dosage regimen

From 0.56 To 0.56 g 2 time(s) per day every day

Detailed description

Dosage of reteplase

Reteplase is administered as a 10 U bolus dose followed by a second 10 U bolus dose 30 minutes later (double bolus).

Each bolus is administered as a slow intravenous injection within 2 minutes. Ensure that the injection is not mistakenly given paravenously.

Heparin and acetylsalicylic acid should be administered before and following the administration of reteplase to reduce the risk of re-thrombosis.

Dosage of Heparin

The recommended dose of heparin is 5000 I.U. given as a bolus injection prior to reteplase therapy followed by an infusion of 1000 I.U. per hour starting after the second reteplase bolus. Heparin should be administered for at least 24 hours, preferably for 48-72 hours, aiming to keep aPTT values 1.5 to 2 times normal.

Dosage of Acetylsalicylic Acid

The initial dose of acetylsalicylic acid prior to thrombolysis should be at least 250 mg (250-350 mg) followed by 75-150 mg/day at least until discharge.

Dosage considerations

Reteplase should be injected preferably through an intravenous line whose sole purpose is the injection of reteplase. No other medicines should be injected through the line reserved for reteplase, neither at the same time, nor prior to, nor following reteplase injection. This applies to all products including heparin, and acetylsalicylic acid, which should be administered before and following the administration of reteplase to reduce the risk of re-thrombosis.

Active ingredient


Reteplase is a recombinant plasminogen activator that catalyzes the cleavage of endogenous plasminogen to generate plasmin. This plasminogenolysis occurs preferentially in the presence of fibrin. Plasmin in turn degrades fibrin, which is the main component of the matrix of thrombi, thereby exerting its thrombolytic action.

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