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Activase (alteplase) Disease Interactions

There is 1 disease interaction with Activase (alteplase):


Thrombolytic agents (applies to Activase) bleeding risks

Major Potential Hazard, High plausibility. Applicable conditions: Cerebral Vascular Disorder, Gastrointestinal Hemorrhage, Hypertension, Retinal Hemorrhage, Infectious Endocarditis

The use of thrombolytics is contraindicated in patients with an active bleed (internal), trauma/surgery (recent CPR/intracranial/intraspinal surgery within 2 months), bleeding diathesis, history of cerebrovascular (CV) accident, intracranial defect (aneurysm, arteriovenous malformation, neoplasm), or severe uncontrolled arterial hypertension (SBP>180/DBP>110). Risk versus benefit should be carefully considered in the following conditions and thrombolytic therapy administered with caution in patients with recent (10 days) serious GI bleed or recent (10 days) surgical procedure (coronary bypass graft, obstetrical delivery, organ biopsy, puncture of noncompressible vessel), left heart thrombus, subacute bacterial endocarditis, hemostatic defect, CV disease, diabetic hemorrhagic retinopathy, or pregnancy. Clinical monitoring of hematopoietic, bleeding and coagulation functions is recommended prior to initiation of thrombolytic therapy. Measures of fibrinolytic activity and/or coagulation functions during infusion do not correlate with efficacy or risk of bleeding.


  1. De Jaegere PP, Arnold AA, Balk AH, Simoons ML "Intracranial hemorrhage in association with thrombolytic therapy: incidence and clinical predictive factors." J Am Coll Cardiol 19 (1992): 289-94
  2. Hanaway J, Torack R, Fletcher AP, Landau WM "Intracranial bleeding associated with urokinase therapy for acute ischemic hemispheral stroke." Stroke 7 (1976): 143-6
  3. "Product Information. Abbokinase Open Cath (urokinase)." Abbott Pharmaceutical, Abbott Park, IL.
  4. Schneeman NJ, Stein EM "Thrombolytic therapy and gastrointestinal bleeding." Am Fam Physician 43 (1991): 53-6,
  5. Kase CS, O'Neal AM, Fisher M, Girgis GN, Ordia JI "Intracranial hemorrhage after use of tissue plasminogen activator for coronary thrombolysis." Ann Intern Med 112 (1990): 17-21
  6. Fromm RE, Hoskins E, Cronin L, Pratt CM, Spencer WH, Roberts R "Bleeding complications following initiation of thrombolytic therapy for acute myocardial infarction: a comparison of helicopter- transported and nontransported patients." Ann Emerg Med 20 (1991): 892-5
  7. Levine MN, Goldhaber SZ, Gore JM, Hirsh J Califf RM "Hemorrhagic complications of thrombolytic therapy in the treatment of myocardial infarction and venous thromboembolism." Chest 108 Suppl (1995): s291-301
  8. Kase CS, Pessin MS, Zivin JA, del Zoppo GJ, Furlan AJ, Buckley JW, Snipes RG, LittleJohn JK "Intracranial hemorrhage after coronary thrombolysis with tissue plasminogen activator." Am J Med 92 (1992): 384-90
  9. "Product Information. Activase (alteplase)." Genentech, South San Francisco, CA.
  10. Topol EJ, Herskowitz A, Hutchins GM "Massive hemorrhagic myocardial infarction after coronary thrombolysis." Am J Med 81 (1986): 339-43
  11. Tisdale JE, Colucci RD, Ujhelyi MR, Kluger J, Fieldman A, Chow MS "Evaluation and comparison of the adverse effects of streptokinase and alteplase." Pharmacotherapy 12 (1992): 440-4
  12. Levine SR, Brott TG "Thrombolytic therapy in cerebrovascular disorders." Prog Cardiovasc Dis 34 (1992): 235-62
  13. "Product Information. Eminase (anistreplase)." SmithKline Beecham, Philadelphia, PA.
  14. Erlemeier HH, Zangemeister W, Burmester L, Schofer J, Mathey DG, Bleifeld W "Bleeding after thrombolysis in acute myocardial infarction." Eur Heart J 10 (1989): 16-23
  15. Maggioni AP, Franzosi MG, Santoro E, White H, Van de Werf F, Tognoni G "The risk of stroke in patients with acute myocardial infarction after thrombolytic and antithrombotic treatment. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico II (GISSI-2), andThe International Study Group." N Engl J Med 327 (1992): 1-6
  16. "Product Information. Streptase (streptokinase)." Astra USA, Westborough, MA.
  17. Berridge DC, Makin GS, Hopkinson BR "Local low dose intra-arterial thrombolytic therapy: the risk of stroke or major haemorrhage." Br J Surg 76 (1989): 1230-3
  18. Haugeberg G, Bonarjee V, Dickstein K "Fatal intrathoracic haemorrhage after cardiopulmonary resuscitation and treatment with streptokinase and heparin." Br Heart J 62 (1989): 157-8
  19. "Product Information. Retavase (reteplase)." Boehringer Mannheim, Gaithersburg, MD.
  20. Dabbs CK, Aaberg TM, Aguilar HE, Sternberg P, Jr Meredith TA, Ward AR "Complications of tissue plasminogen activator therapy after vitrectomy for diabetes." Am J Ophthalmol 110 (1990): 354-60
  21. McNeill AJ, Roberts MJ, Wilson CM, Dalzell GW, Dickey W, Flannery DJ, Campbell NP, Khan MM, Molajo AO, Patterson GC, et al "Anistreplase in early acute myocardial infarction and the one-year follow-up." Int J Cardiol 31 (1991): 39-49
  22. Brenot F, Pacouret G, Meyer G, Sors H, Charbonnier B, Simonneau G "Adverse reactions with anistreplase." Lancet 338 (1991): 114-5
  23. Aldrich MS, Sherman SA, Greenberg HS "Cerebrovascular complications of streptokinase infusion." JAMA 253 (1985): 1777-9
  24. Califf RM, Topol EJ, George BS, Boswick JM, Abbottsmith C, Sigmon KN, Candela R, Masek R, Kereiakes D, O'Neill WW, et al "Hemorrhagic complications associated with the use of intravenous tissue plasminogen activator in treatment of acute myocardial infarction." Am J Med 85 (1988): 353-9
  25. London NJ, Williams B, Stein A "Systemic thrombolysis causing haemorrhage around a prosthetic abdominal aortic graft." BMJ 306 (1993): 1530-1
  26. Wagstaff AJ, Gillis JC, Goa KL "Alteplase - a reappraisal of its pharmacology and therapeutic use in vascular disorders other than acute myocardial infarction." Drugs 50 (1995): 289-316
  27. McLeod DC, Coln WG, Thayer CF, Perfetto EM, Hartzema AG "Pharmacoepidemiology of bleeding events after use of r-alteplase or streptokinase in acute myocardial infarction." Ann Pharmacother 27 (1993): 956-62
  28. Hirsch DR, Goldhaber SZ "Bleeding time and other laboratory tests to monitor the safety and efficacy of thrombolytic therapy." Chest 97 (1990): s124-31
  29. Garcia-Rubira JC, Lopez V, Rojas J, Garcia-Martinez JT, Cruz JM "Thrombolytic therapy soon after left heart catheterization--is it safe?" Intensive Care Med 17 (1991): 501-3
View all 29 references

Activase (alteplase) drug interactions

There are 148 drug interactions with Activase (alteplase)

Activase (alteplase) alcohol/food interactions

There is 1 alcohol/food interaction with Activase (alteplase)

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.