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:
1.12 - 1.12 g
From 0.56 To 0.56 g 2 time(s) per day every day
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.
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.
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.
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.