Urokinase

CLINICAL USE

Fibrinolytic agent: Thrombosed arteriovenous shunts and intravenous cannulas Treatment of thromboembolic occlusive vascular disease, e.g. DVT, PE, peripheral vascular occlusion

DOSE IN NORMAL RENAL FUNCTION

Lock: 5000–250 000 IU for 30 minutes – 2 hours Infusion: 5000–250 000 IU over 30 minutes – 48 hours, depending on local protocol

PHARMACOKINETICS

Molecular weight : 33 000–54 000

%Protein binding : No data

%Excreted unchanged in urine : Low

Volume of distribution (L/kg) : No data

half-life – normal/ESRD (hrs) : 20 minutes/Increased

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD : Not dialysed. Dose as in normal renal function

HD : Not dialysed. Dose as in normal renal function

HDF/high flux : Unknown dialysability. Dose as in normal renal function

CAV/VVHD : Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

None known

ADMINISTRATION

Reconstition

2 mL of sodium chloride 0.9%

Route

–

Rate of Administration

Various

Comments

–

OTHER INFORMATION

Doses from Kumwenda M, Cornall A, Corner L, et al. Urokinase for dysfunctional haemodialysis catheters. Br J Renal Med. 2005; 10(3): 10–11 Can also be given during dialysis Care in patients with uraemic coagulopathies or bleeding diatheses Some units mix 5000 IU with 1.5 mL heparin 1000 u/mL .

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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