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Alteplase
What it does
Alteplase is a medication used to dissolve blood clots in the body.
Commonly used for: heart attack (myocardial infarction), stroke, pulmonary embolism
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Source: Pharmacy and Poisons Board · fetched 2026-08-27 13:06:48 · updated 2026-10-20 02:04:27
About this medicine
Alteplase is a medication used to dissolve blood clots in the body.
What it treats
- heart attack (myocardial infarction)
- stroke
- pulmonary embolism
How it works
Alteplase works by breaking down the clots that block blood vessels, helping to restore normal blood flow.
Who it's for
Alteplase is for adults experiencing severe blood clots that can cause serious health issues.
Cautions
- • Should be used with caution if you are taking other medications that thin the blood.
AI-assisted summary grounded in BNF data - general information only, not medical advice. Always confirm with your pharmacist or doctor.
Clinical monograph: Alteplase
BNF-referencedAlteplase is a thrombolytic medication used to dissolve intravascular thrombi and unblock occluded central venous access devices, including those used for haemodialysis.
Indications
- Intravascular thrombosis
- Blocked catheters and lines
- Blood clots
Dosage
Children: Neonate: 100–500 micrograms/kg/hour for 3–6 hours; consult local protocol for further dosing guidance.
Adults: For intravenous administration, the typical dose is 100 mg total, infused over 2 hours. Adjustments may be needed based on clinical response and specific conditions.
Mechanism of action
Alteplase acts as a fibrinolytic agent by activating plasminogen to form plasmin, which degrades fibrin and breaks up thrombi.
Pharmacodynamics
Alteplase increases the rate of fibrinolysis by converting plasminogen to plasmin, leading to the breakdown of fibrin clots. It is particularly effective in the treatment of acute thromboembolic events.
Pharmacokinetics
Alteplase is administered intravenously and has a short half-life. It is rapidly distributed in the bloodstream, with effects generally observed within minutes. Metabolism occurs in the liver and clearance is mainly via the reticuloendothelial system. Specific pharmacokinetic parameters in children may vary and should be monitored during therapy.
Contra-indications
- Recent delivery
- Recent ulcerative gastrointestinal disease
- Acute pancreatitis
- Aneurysm
- Bacterial endocarditis
- Bleeding diatheses
- Coagulation defects
- Neoplasm with risk of haemorrhage
- Pericarditis
- Recent haemorrhage
- Recent surgery (including dental extraction)
- Recent trauma
- Severe hypertension
- Oesophageal varices
- Recent stroke
Adverse effects
- Serious bleeding
- Haemothorax
- Agitation
- Confusion
- Delirium
- Depression
- Epilepsy
- Psychosis
- Speech disorder
- Brain oedema (caused by reperfusion)
Precautions
- The safety and efficacy of treatment remains uncertain, especially in neonates.
- A fibrinolytic drug is probably only appropriate where arterial occlusion threatens ischaemic damage.
- An anticoagulant may stop the clot from enlarging.
Pregnancy
Thrombolytic drugs can possibly lead to premature separation of the placenta in the first 18 weeks of pregnancy. There is also a risk of maternal haemorrhage throughout pregnancy and post-partum, and a theoretical risk of fetal haemorrhage throughout pregnancy.
Breast-feeding
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Storage
Protect infusion from light. Use polyethylene, polypropylene, or glass apparatus.
Formulations
- Intravenous infusion solution
AI-synthesized from BNF references - general information only, not a substitute for professional medical advice or the current BNF. Verify doses with a pharmacist.
This drug in other countries
The same active ingredient registered across other registries we cover - including different brands.