Usual Adult Dose for Pulmonary Embolism

Initial dose: 4400 international units/kg IV at a rate of 90 mL/hr over 10 minutes

Maintenance dose: 4400 international units/kg/hr IV at a rate of 15 mL for 12 hours

Comments:

• Institute treatment soon after onset of pulmonary embolism to avoid potential decrease in efficacy.
• Administration of this drug may be repeated as necessary.
• After infusing this drug, do not begin anticoagulation until activated partial thromboplastin time (aPTT) has decreased to less than twice the normal control value; if heparin is used, do not administer a loading dose of heparin; treatment should be followed by oral anticoagulants.

• Lysis of acute massive pulmonary emboli (obstruction of blood flow to a lobe or multiple segments).
• Lysis of pulmonary emboli accompanied by unstable hemodynamics (e.g., failure to maintain blood pressure without supportive measures).

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component or any of the ingredients
• Active internal bleeding
• Recent cerebrovascular accident (within two months)
• Recent intracranial or intraspinal surgery (within two months)
• Recent trauma including cardiopulmonary resuscitation
• Intracranial neoplasm, arteriovenous malformation, or aneurysm
• Known bleeding diatheses
• Severe uncontrolled arterial hypertension

Dialysis

Data not available

Other Comments

Administration advice:

• This drug is intended only for intravenous infusion.
• The manufacturer product information should be consulted.

• Hematologic: Hematocrit, platelet count, and activated partial thromboplastin time (aPTT) should be obtained prior to starting treatment
• General: Vital signs should be observed frequently during and following infusion (blood pressure should not be taken in lower extremities to avoid dislodgement of possible deep vein thrombus)