alteplase at a glance
Medicine class
Thrombolytic, also called a fibrinolytic or clot-busting treatment.
Usual uses
Selected cases of acute ischaemic stroke, acute myocardial infarction and haemodynamically unstable pulmonary embolism.
Administration
Given intravenously by an experienced hospital team with facilities for close monitoring and resuscitation.
Main safety concern
Bleeding, including potentially life-threatening intracranial or internal bleeding.
What is alteplase used for?
The selected UK product is licensed for systemic thrombolysis in carefully assessed patients.
Acute myocardial infarction.
Acute massive pulmonary embolism with haemodynamic instability.
Acute ischaemic stroke after brain imaging has excluded intracranial haemorrhage.
How does alteplase work?
Alteplase is a recombinant form of human tissue-type plasminogen activator. It becomes more active when bound to fibrin in a clot and converts plasminogen into plasmin, which breaks down the clot's fibrin framework and can restore blood flow.
How to take alteplase
Alteplase is not taken by mouth or self-administered. A hospital professional reconstitutes the powder and gives the solution into a vein; the solution is intended for immediate use and the patient is closely observed for bleeding and other complications.
Food does not affect its administration.
Avoid unnecessary injections, punctures and invasive handling around treatment where possible.
The solution must not be mixed with other medicines in the same container or catheter.
alteplase side effects
Common or expected effects
- Bleeding is the most frequent adverse effect and may occur at puncture sites or internally.
- Bruising and gastrointestinal, urinary or mouth bleeding can occur.
Get urgent medical advice
- Bleeding in or around the brain, or other major internal bleeding.
- Angioedema, causing swelling of the lips, tongue or throat; the risk may be higher with an ACE inhibitor.
- Severe allergic reaction.
- Serious cardiac rhythm or circulatory complications, particularly during treatment for myocardial infarction.
alteplase in pregnancy
Experience during pregnancy is limited. Because alteplase may cause serious bleeding, specialists must weigh the potential maternal benefit against fetal and pregnancy-related risks when treating an acute life-threatening condition.
alteplase while breastfeeding
It is unknown whether alteplase passes into human milk. The product information advises an individual decision about interrupting breastfeeding for the first 24 hours after treatment, discussed with the specialist team.
alteplase interactions
The treating team needs an urgent and complete record of prescribed, over-the-counter and recently stopped medicines.
Anticoagulants, including warfarin, heparins and direct oral anticoagulants
Existing anticoagulation may substantially increase bleeding risk and can make alteplase unsuitable, depending on the medicine, timing and coagulation results.
Antiplatelets, including aspirin and clopidogrel
Platelet inhibition increases bleeding risk; use around alteplase requires indication-specific specialist assessment.
Glycoprotein IIb/IIIa inhibitors
Concomitant use increases bleeding risk.
Common questions about alteplase
Answers are fully visible for fast scanning and source review.
What is alteplase used for?
The selected product is licensed for selected patients with acute myocardial infarction, haemodynamically unstable massive pulmonary embolism or acute ischaemic stroke.
Is alteplase a clot-busting treatment?
Yes. It activates the body's plasmin system to break down the fibrin framework of a blood clot.
How is alteplase given?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.