transderm-nitro and Activase Interactions

Interactions between transderm-nitro(nitroglycerin) and Activase (alteplase)

nitroglycerin and alteplase (Moderate Drug-Drug)

MONITOR: Limited data suggest that average plasma tPA levels and tPA-induced thrombolysis may be significantly reduced in the presence of nitroglycerin. The mechanism is not known, but may be due to nitroglycerin-induced increases in hepatic blood flow, which may result in increased hepatic metabolism of tPA. Isosorbide may theoretically also have an effect.

MANAGEMENT: While more data are needed, clinicians are warned of the possibility of decreased effectiveness of alteplase when these drugs are given together.