Alteplase


Alteplase is a thrombolytic medication, used to treat acute ST elevation myocardial infarction, pulmonary embolism associated with low blood pressure, acute ischemic stroke, and blocked central venous access devices. It is given by injection into a vein or artery.
Common side effects are bleeding including intracranial bleeding and GI bleeding. Other side effects may rarely include allergic reactions. It is not recommended in those allergic to gentamicin. Safety of use in pregnancy is unclear. Alteplase is a manufactured form of tissue plasminogen activator. It works by converting plasminogen to plasmin in a blood clot.
Alteplase was approved for medical use in the United States in 1987. It is on the World Health Organization's List of Essential Medicines, the safest and most effective medicines needed in a health system.

Medical uses

The main uses of alteplase are acute ischemic stroke, acute myocardial infarction, and acute massive pulmonary embolism.
In regards to acute myocardial infarction, a randomized controlled trial of people with acute STEMI, showed there was no reduction in microvascular obstruction when adjunctive low-dose intracoronary alteplase was administered during the primary PCI.

Mechanism of action

Alteplase is a serine protease that assists fibrin in the conversion of plasminogen to plasmin. When in the systemic circulation, alteplase binds to fibrin in a thrombus and initiates fibrinolysis.

Society and culture

It is on the World Health Organization's List of Essential Medicines, having been added in 2019.