Alteplase is a medication used to break up blood clots in emergency situations. It is usually given through an intravenous (IV) drip in the arm or through a catheter running to a major blood vessel in the chest or neck. Patients who experience acute heart attacks, strokes, or pulmonary embolisms are often given alteplase injections to immediately resolve clots and prevent symptoms from worsening. The drug is also used during chemotherapy treatment to stop or prevent clotting in central venous ports. The risks of side effects, adverse drug interactions, and serious complications are low with alteplase use.
Doctors classify alteplase as a tissue plasminogen activator. In the bloodstream, the drug interacts with a substance called plasminogen to convert it into plasmin enzymes. Plasmin is essential in breaking down the proteins responsible for blood clotting. Alteplase quickly dissolves stubborn clots in veins and arteries and allows blood to flow more easily through constricted blood vessels.
The medication is administered immediately when a patient is suffering from a clot-related condition. It is used to clear up blood clots in the brain that cause strokes, blockages in the lungs that lead to embolisms, and obstructions in or near the heart that cause infarction. The drug can also be used in non-life-threatening circumstances. Some chemotherapy patients have ports implanted in their chests to deliver medications directly to central blood vessels. Alteplase can be injected into a port if it gets clogged with blood and hinders medication delivery.
Alteplase is typically given as a slow IV drip over the course of one to three hours. Slow delivery is important to ensure that clots do not return while other life-saving treatment measures are taken. The exact amount administered and the rate of delivery vary based on a patient's weight, age, and specific condition. Patients rarely receive more than a 100-milligram dose to prevent blood from becoming too thin.
Side effects are rare with alteplase, and most complications that people experience are related to their underlying health condition or other drugs used in emergency treatment. An individual may feel nauseous, dizzy, or lightheaded immediately after receiving an injection. Hemorrhaging is a concern in a small number of patients, and blood may begin to spill from the nose, gums, injection site, or skin wounds. An allergic reaction to the drug may cause a racing heartbeat, chest tightness, throat and tongue swelling, and skin reactions. Doctors carefully monitor patients during drug administration to check for signs of adverse effects and treat them accordingly.