Classifications: thrombolytic enzyme, tissue plasminogen activator; Therapeutic: thrombolytic
Pregnancy Category: C
10.4 IU vials
DNA recombinant human tissue-type plasminogen activator (t-PA) that acts as a catalyst in the cleavage of plasminogen to
plasmin. Responsible for degrading the fibrin matrix of a clot.
Has antithrombolytic properties.
Thrombolysis management of acute MI to reduce the incidence of CHF and mortality.
Active internal bleeding, history of CVA, recent neurological surgery or trauma, intercranial neoplasm, or aneurysm, bleeding
disorders, severe uncontrolled hypertension; pregnancy (category C).
Any condition in which bleeding constitutes a significant hazard (i.e., severe hepatic or renal disease, CVA, hypertension,
acute pancreatitis, septic thrombophlebitis); lactation. Safety and efficacy in children are not established.
Route & Dosage
|Thrombolysis during Acute MI
Adult: IV 10 U injected over 2 min. Repeat dose in 30 min (20 U total).
PREPARE: Direct: Reconstitute using only the diluent, syringe, needle, and dispensing pin provided with reteplase. Withdraw diluent with syringe
provided. Remove needle from syringe, replace with dispensing pin and transfer diluent to vial of reteplase. Leave pin and
syringe in place in vial and swirl to dissolve. Do NOT shake. When completely dissolved, remove 10 mL solution, replace
dispensing pin with a 20-gauge needle.
ADMINISTER: Direct: Flush IV line before & after with 30 mL NS or D5W and do NOT give any other drug simultaneously through the same IV line. Give a single dose evenly over 2 min.
INCOMPATIBILITIES Solution/additive: Heparin. Y-site: Bivalirudin, heparin.
- Store drug kit unopened at 2°25° C (36°77° F).
Adverse Effects (≥1%)Hematologic: Hemorrhage
GI, genitourinary), anemia
Diagnostic Test Interference
Causes decreases in plasminogen and fibrinogen, making coagulation and fibrinolytic tests unreliable.
InteractionsDrug: Aspirin, abciximab, dipyridamole, heparin
may increase risk of bleeding.
In urine. Half-Life:
Assessment & Drug Effects
- Discontinue concomitant heparin immediately if serious bleeding not controllable by local pressure occurs and, if not already
given, withhold the second reteplase bolus.
- Monitor carefully all potential bleeding sites; monitor for S&S of internal hemorrhage (e.g., GI, GU, intracranial, retroperitoneal,
- Monitor carefully cardiac status for arrhythmias associated with reperfusion.
- Avoid invasive procedures, arterial and venous punctures, IM injections, and nonessential handling of the patient during
Patient & Family Education
- Report changes in consciousness or signs of bleeding to physician immediately.