Alteplase, Recombinant, Injection AL-teh-place ree-KOM-be-nant

What are other names for this medicine?

Type of medicine: tissue plasminogen activator; thrombolytic

Generic and brand names: alteplase, recombinant, injection; Activase; Cathflo Activase

What is this medicine used for?

This medicine is given by IV infusion (slow drip into a large vein) to treat heart attacks and acute ischemic stroke in adults by dissolving blood clots. It is also used to treat blood clots in the lungs (called pulmonary embolism). A small amount may be used to clear a blood clot from a catheter. This medicine may be used for other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• a brain tumor or other brain disease
• a stroke
• bleeding problems
• blood vessel problems or blood clots
• eye problems related to diabetes
• high blood pressure or other heart problems
• liver or kidney disease
• ulcers

Tell your healthcare provider if you have recently been injured, had an infection, had a baby, or had surgery.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine works best when given at the first symptoms of a heart attack or within 3 to 4.5 hours after the first symptoms of a stroke. The infusions are usually given in a hospital.

You may also receive other medicines along with this medicine to help keep clots from forming.

What should I watch out for?

Receiving this treatment as soon as possible after you have symptoms of a heart attack or stroke improves your chances of recovery.

To help prevent serious bleeding, carefully follow the instructions given by your healthcare provider. Watch for signs of bleeding around your IV and check for blood in your urine or stools. While you are receiving this medicine, your healthcare provider will carefully watch you for any serious side effects. Tell your healthcare provider right away if you notice any bleeding.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you have received this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Your healthcare provider will watch you closely to make sure the medicine is working and is not causing unwanted side effects. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider): Unusual bleeding or bruising, bloody or black tarry bowel movements; blood in the urine; irregular heartbeat; chest pain; sudden or severe headache; sudden changes in vision; blue or purple toes; trouble urinating; shortness of breath; joint or muscle pain.

Other: Nausea, vomiting, fever, dizziness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), quinapril (Accupril), and ramipril (Altace)
• aspirin or other salicylates
• medicine that reduces the chance of blood clots forming such as abciximab (ReoPro), cilostazol (Pletal), clopidogrel (Plavix), dalteparin (Fragmin), dipyridamole (Persantine), enoxaparin (Lovenox), eptifibatide (Integrilin), fondaparinux (Arixtra), heparin, tirofiban (Aggrastat), and warfarin (Coumadin)
• natural remedies such as cat's claw, dong quai, evening primrose, feverfew, garlic, ginkgo, ginseng, green tea, horse chestnut, and red clover
• NSAIDS such as celecoxib (Celebrex), ibuprofen (Motrin, Motrin IB, Advil), indomethacin (Indocin), ketoprofen, ketorolac (Toradol), nabumetone (Relafen), naproxen (Aleve, Naprosyn, Naprelan, Anaprox), oxaprozin (Daypro), and sulindac (Clinoril)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.