Kinlytic Disease Interactions

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.

Urokinase undergoes extensive clearance and degradation by the liver. The pharmacokinetic disposition of urokinase has not been fully determined, however it is expected that the half-life of urokinase would be prolonged in patients with hepatic impairment. Therapy with urokinase should be administered cautiously in patients with compromised hepatic function. Clinical monitoring of bleeding functions should be determined prior to initiation of therapy. Measures of fibrinolytic activity and/or coagulation functions during infusion do not correlate with efficacy or risk of bleeding.