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reteplase

Generic Name: reteplase (RE te plase)
Brand Name: Retavase

What is reteplase?

Reteplase is a thrombolytic (THROM-bo-LIT-ik) drug, sometimes called a "clot-busting" drug. It helps your body produce a substance that dissolves unwanted blood clots.

Reteplase is used to improve heart function and prevent congestive heart failure or death in people who have had a heart attack (acute myocardial infarction).

Reteplase may also be used for purposes not listed in this medication guide.

What is the most important information I should know about reteplase?

If possible before you receive reteplase, tell your doctor if you have a brain tumor or aneurysm, high blood pressure, hemophilia or other bleeding disorder, a history of stroke, or if you have recently had a head injury or surgery on your brain or spinal cord.

In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received this medicine.

What should I discuss with my health care provider before I receive reteplase?

You should not be treated with reteplase if you are allergic to it, or if you have:

  • active bleeding inside your body;

  • a bleeding or blood clotting disorder such as hemophilia;

  • a brain tumor or blood vessel disorder;

  • a brain aneurysm (dilated blood vessel);

  • untreated or uncontrolled high blood pressure;

  • a history of stroke; or

  • a recent history of head injury, or surgery on your brain or spinal cord.

If possible before you receive reteplase, tell your doctor if you have:

  • a recent major surgery, medical trauma, or injury;

  • a recent history of bleeding in your brain, stomach, intestines, or urinary tract;

  • a past history of strokes;

  • high blood pressure;

  • heart problems;

  • an infection of the lining of your heart (also called bacterial endocarditis);

  • liver or kidney disease;

  • eye problems caused by diabetes;

  • severe bruising or infection around a vein where an IV was placed;

  • if you have recently had an organ biopsy; or

  • if you are pregnant or have recently had a baby.

In an emergency situation it may not be possible to tell your caregivers if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medicine.

How is reteplase given?

Reteplase is injected into a vein through an IV. A healthcare provider will give you this injection.

Reteplase is usually given in two injections 30 minutes apart.

This medication can cause you to have unusual results with certain medical tests. Tell any doctor who treats you that you have received reteplase.

What happens if I miss a dose?

Since reteplase is given only when needed by a healthcare professional, it is not likely that you will miss a dose.

What happens if I overdose?

Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving reteplase?

Ask your doctor before taking aspirin or ibuprofen (Motrin, Advil) shortly after you have received reteplase. These medications can increase your risk of bleeding.

Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.

Reteplase side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Reteplase increases your risk of bleeding, which can be severe or life-threatening. Call your doctor or seek emergency medical attention if you have bleeding that will not stop. Bleeding may occur from a surgical incision, or from the skin where a needle was inserted during a blood test or while receiving injectable medication. You may also have bleeding on the inside of your body, such as in your stomach or intestines, kidneys or bladder, brain, or within the muscles.

Call your doctor at once if you have signs of bleeding inside your body, such as:

  • easy bruising or bleeding (nosebleeds, bleeding gums, bleeding from a wound, incision, catheter, or needle injection);

  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;

  • red or pink urine; or

  • sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance.

Also call your doctor at once if you have:

  • chest pain or heavy feeling, pain spreading to the jaw or shoulder, nausea, sweating, general ill feeling;

  • swelling, rapid weight gain, little or no urinating;

  • severe stomach pain, nausea, and vomiting

  • darkening or purple discoloration of your fingers or toes;

  • very slow heartbeats, shortness of breath, feeling light-headed;

  • sudden severe back pain, muscle weakness, numbness or loss of feeling in your arms or legs,

  • dangerously high blood pressure--severe headache, blurred vision, pounding in your neck or ears, nosebleed, anxiety, confusion, severe chest pain, shortness of breath, irregular heartbeats; or

  • pancreatitis--severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate.

Common side effects may include:

  • nausea, vomiting; or

  • fever.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Reteplase dosing information

Usual Adult Dose for Myocardial Infarction:

10 units administered over 2 minutes as an IV bolus as soon as possible after the onset of acute myocardial infarction (AMI) symptoms, followed 30 minutes later by a second 10 unit IV bolus injection also administered over 2 minutes.

If serious bleeding (not controllable by local pressure) occurs before the administration of the second bolus, terminate any concomitant anticoagulant therapy and do not administer the second reteplase bolus.

Half dose reteplase (5 units) has been used in the GUSTO V trial in combination with abciximab.

What other drugs will affect reteplase?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • a blood thinner (heparin, warfarin, Coumadin, Jantoven);

  • NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or

  • medication used to prevent blood clots--abciximab, eptifibatide, tirofiban, vorapaxar.

This list is not complete. Other drugs may interact with reteplase, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about reteplase.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01.

Date modified: April 03, 2017
Last reviewed: February 08, 2017

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