reteplase

CLINICAL USE

Thrombolytic, used for acute myocardial infarction

DOSE IN NORMAL RENAL FUNCTION

10 units over 2 minutes; second dose of 10 units given 30 minutes later

PHARMACOKINETICS

Molecular weight :39571.1

%Protein binding :No data

%Excreted unchanged in urine : Negligible

Volume of distribution (L/kg) :6–6.5 litres

half-life – normal/ESRD (hrs) :Fibrinolytic half-life is 1.6 hours./IncreasedDominant (α) half-life is 14.6 +/– 6.7 minutesTerminal (β) half-life is 1.6 hrs +/– 39 minutes

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. Use with caution

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAntiplatelets, heparin, vitamin K antagonists: increased risk of bleeding

ADMINISTRATION

Reconstition

With diluent provided

Route

Slow IV

Rate of Administration

Over not more than 2 minutes

Comments

Use immediately once reconstituted Do not mix with heparin in the same line

OTHER INFORMATION

Heparin and aspirin should be given before and after reteplase therapy to reduce the risk of re-thrombosis but may increase the risk of bleedingHalf-life is increased in severe renal failure in animal modelsPossible increased risk of bleeding complications in severe renal impairment.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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