Reteplase recombinant
Reteplase recombinant (Retavase)
Reteplase recombinant
( REE-teh-place)
Pregnancy Category: C Retavase (Rx)

Classification: Inhibitor of platelet aggregation

Action/Kinetics: Plasminogen activator that catalyzes the cleavage of endogenous plasminogen to generate plasmin. Plasmin, in turn, degrades the matrix of the thrombus, causing a thrombolytic effect. t 1/2: 13 to 16 min. Cleared primarily by the liver and kidney.

Uses: In adults for the management of acute MI for improvement of ventricular function, reduction of the incidence of CHF, and reduction of mortality.

Contraindications: Active internal bleeding; history of CVA; recent intracranial or intraspinal surgery or trauma; intracranial neoplasm, arteriovenous malformation, or aneurysm; known bleeding diathesis; severe uncontrolled hypertension.

Special Concerns: Use with caution during lactation. Safety and efficacy have not been determined in children.

Side Effects: Bleeding disorders: From internal bleeding sites, including intracranial, retroperitoneal, GI, GU, or respiratory. Hemorrhage may occur. From superficial bleeding sites, including venous cutdowns, arterial punctures, sites of recent surgery. CV: Cholesterol embolism coronary thrombolysis resulting in arrhythmias associated with perfusion (no different from those seen in the ordinary course of acute MI), cardiogenic shock, sinus bradycardia, accelerated idioventricular rhythm, ventricular premature depolarizations, SVT, ventricular tachycardia, ventricular fibrillation AV block, pulmonary edema, heart failure, cardiac arrest, recurrent ischemia, myocardial rupture, cardiac tamponade, venous thrombosis or embolism, electromechanical dissociation, mitral regurgitation, pericardial effusion, pericarditis. Hypersensitivity: Serious allergic reactions. NOTE: Many of the CV side effects listed are frequent sequelae of MI and may or may not be attributable to reteplase recombinant.

Laboratory Test Alterations: Plasminogen, fibrinogen. Degradation of fibrinogen in blood samples removed for analysis.

Drug Interactions: Use with abciximab, aspirin, dipyridamole, heparin, or vitamin K antagonists may increase the risk of bleeding.

How Supplied: Kit: 10.8 mg

Dosage
?IV only Acute MI.
Adults: 10 + 10 unit double-bolus. Each bolus is given over 2 min, with the second bolus given 30 min after initiation of the first bolus injection.