Alteplase

Actilyse

Presentation and preparation

Reconstitute powder vial with the water for injections provided to give a 1 mg/mL solution. Swirl gently, do not shake.

RCH: 1.5 mg/1.5 mL frozen solution syringe. For management of blocked Central Venous Access Device (CVAD) only.

IV administration

Use undiluted. If necessary, dilute to 0.25 mg/mL or stronger. Use diluted solution immediately.

Blocked Central Venous Access Device: 

Refer to RCH Insertion, Management and Removal of Central Venous Access Devices, or relevant local guideline.

Instill alteplase into the blocked line for 2 to 4 hours, then withdraw dose. If possible, flush with sodium chloride 0.9% and attempt to aspirate blood.

Acute Ischaemic Stroke: 

Refer to RCH Clinical Practice Guidelines, Alteplase for Ischaemic Stroke or relevant local guideline.

Loading dose: Give as a rapid injection over 1 minute. Give the remainder of the dose as an infusion over 1 hour.

Other routes of administration

IM: Contraindicated.

SC: Not recommended.

Compatible IV fluids

Alteplase 0.25 mg/mL or stronger:

Sodium chloride 0.9% (8 hours only)

Additional information

Extravasation risk.

Observe closely for anaphylactic reactions.

Monitor for angioedema during and for up to 24 hours after infusion. If a severe hypersensitivity reaction occurs (e.g. angioedema), discontinue the infusion.

Avoid giving any IM injections during therapy, due to the risk of bleeding.

Use only when facilities for cardiac monitoring and cardio-respiratory resuscitation exist.

Reconstituted solution should be clear and colourless to pale yellow.

Contains non-latex rubber.

Protect from light during storage.

RCH 1.5 mg/1.5 mL frozen solution syringes need to be thawed at room temperature prior to use.