Skip to main content

Alteplase and Alcohol/Food Interactions

There is 1 alcohol/food/lifestyle interaction with alteplase.

Major

Alteplase High Blood Pressure (Hypertension)

Major Potential Hazard, High plausibility

thrombolytic agents - bleeding risks

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.

References

  1. Kase CS, Pessin MS, Zivin JA, del Zoppo GJ, Furlan AJ, Buckley JW, Snipes RG, LittleJohn JK (1992) "Intracranial hemorrhage after coronary thrombolysis with tissue plasminogen activator." Am J Med, 92, p. 384-90
  2. Califf RM, Topol EJ, George BS, Boswick JM, Abbottsmith C, Sigmon KN, Candela R, Masek R, Kereiakes D, O'Neill WW, et al. (1988) "Hemorrhagic complications associated with the use of intravenous tissue plasminogen activator in treatment of acute myocardial infarction." Am J Med, 85, p. 353-9
  3. Topol EJ, Herskowitz A, Hutchins GM (1986) "Massive hemorrhagic myocardial infarction after coronary thrombolysis." Am J Med, 81, p. 339-43
  4. Dabbs CK, Aaberg TM, Aguilar HE, Sternberg P, Jr Meredith TA, Ward AR (1990) "Complications of tissue plasminogen activator therapy after vitrectomy for diabetes." Am J Ophthalmol, 110, p. 354-60
  5. Fromm RE, Hoskins E, Cronin L, Pratt CM, Spencer WH, Roberts R (1991) "Bleeding complications following initiation of thrombolytic therapy for acute myocardial infarction: a comparison of helicopter- transported and nontransported patients." Ann Emerg Med, 20, p. 892-5
  6. Kase CS, O'Neal AM, Fisher M, Girgis GN, Ordia JI (1990) "Intracranial hemorrhage after use of tissue plasminogen activator for coronary thrombolysis." Ann Intern Med, 112, p. 17-21
  7. Maggioni AP, Franzosi MG, Santoro E, White H, Van de Werf F, Tognoni G (1992) "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, p. 1-6
  8. Garcia-Rubira JC, Lopez V, Rojas J, Garcia-Martinez JT, Cruz JM (1991) "Thrombolytic therapy soon after left heart catheterization--is it safe?" Intensive Care Med, 17, p. 501-3
  9. Tisdale JE, Colucci RD, Ujhelyi MR, Kluger J, Fieldman A, Chow MS (1992) "Evaluation and comparison of the adverse effects of streptokinase and alteplase." Pharmacotherapy, 12, p. 440-4
  10. Brenot F, Pacouret G, Meyer G, Sors H, Charbonnier B, Simonneau G (1991) "Adverse reactions with anistreplase." Lancet, 338, p. 114-5
  11. McNeill AJ, Roberts MJ, Wilson CM, Dalzell GW, Dickey W, Flannery DJ, Campbell NP, Khan MM, Molajo AO, Patterson GC, et al. (1991) "Anistreplase in early acute myocardial infarction and the one-year follow-up." Int J Cardiol, 31, p. 39-49
  12. Hirsch DR, Goldhaber SZ (1990) "Bleeding time and other laboratory tests to monitor the safety and efficacy of thrombolytic therapy." Chest, 97, s124-31
  13. Levine SR, Brott TG (1992) "Thrombolytic therapy in cerebrovascular disorders." Prog Cardiovasc Dis, 34, p. 235-62
  14. Hanaway J, Torack R, Fletcher AP, Landau WM (1976) "Intracranial bleeding associated with urokinase therapy for acute ischemic hemispheral stroke." Stroke, 7, p. 143-6
  15. Erlemeier HH, Zangemeister W, Burmester L, Schofer J, Mathey DG, Bleifeld W (1989) "Bleeding after thrombolysis in acute myocardial infarction." Eur Heart J, 10, p. 16-23
  16. Schneeman NJ, Stein EM (1991) "Thrombolytic therapy and gastrointestinal bleeding." Am Fam Physician, 43, 53-6,
  17. Haugeberg G, Bonarjee V, Dickstein K (1989) "Fatal intrathoracic haemorrhage after cardiopulmonary resuscitation and treatment with streptokinase and heparin." Br Heart J, 62, p. 157-8
  18. Berridge DC, Makin GS, Hopkinson BR (1989) "Local low dose intra-arterial thrombolytic therapy: the risk of stroke or major haemorrhage." Br J Surg, 76, p. 1230-3
  19. De Jaegere PP, Arnold AA, Balk AH, Simoons ML (1992) "Intracranial hemorrhage in association with thrombolytic therapy: incidence and clinical predictive factors." J Am Coll Cardiol, 19, p. 289-94
  20. Aldrich MS, Sherman SA, Greenberg HS (1985) "Cerebrovascular complications of streptokinase infusion." JAMA, 253, p. 1777-9
  21. London NJ, Williams B, Stein A (1993) "Systemic thrombolysis causing haemorrhage around a prosthetic abdominal aortic graft." BMJ, 306, p. 1530-1
  22. McLeod DC, Coln WG, Thayer CF, Perfetto EM, Hartzema AG (1993) "Pharmacoepidemiology of bleeding events after use of r-alteplase or streptokinase in acute myocardial infarction." Ann Pharmacother, 27, p. 956-62
  23. (2001) "Product Information. Eminase (anistreplase)." SmithKline Beecham
  24. (2022) "Product Information. Abbokinase Open-Cath (urokinase)." Abbott Pharmaceutical
  25. (2001) "Product Information. Activase (alteplase)." Genentech
  26. (2001) "Product Information. Streptase (streptokinase)." Astra-Zeneca Pharmaceuticals
  27. Wagstaff AJ, Gillis JC, Goa KL (1995) "Alteplase - a reappraisal of its pharmacology and therapeutic use in vascular disorders other than acute myocardial infarction." Drugs, 50, p. 289-316
  28. Levine MN, Goldhaber SZ, Gore JM, Hirsh J Califf RM (1995) "Hemorrhagic complications of thrombolytic therapy in the treatment of myocardial infarction and venous thromboembolism." Chest, 108 Suppl, s291-301
  29. (2001) "Product Information. Retavase (reteplase)." Boehringer Mannheim
View all 29 references

Alteplase drug interactions

There are 154 drug interactions with alteplase.

Alteplase disease interactions

There is 1 disease interaction with alteplase which include:

Report options

Loading...
QR code containing a link to this page

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.

Medical Disclaimer