• Acute myocardial infarction (MI).

Unlabeled Use:

• Occluded central venous access devices.
• Deep venous thrombosis (DVT).
• Acute peripheral arterial thrombosis.

Contraindicated in:

• Active internal bleeding
• History of cerebrovascular accident
• Recent (within 2 mo) intracranial or intraspinal injury or trauma
• Intracranial neoplasm, arteriovenous malformation, or aneurysm
• Severe uncontrolled hypertension
• Known bleeding tendencies
• Hypersensitivity.

Use Cautiously in:

• Recent (within 10 days) major surgery, trauma, GI or GU bleeding
• Left heart thrombus
• Severe hepatic or renal disease
• Hemorrhagic ophthalmic conditions
• Septic phlebitis
• Previous puncture of a noncompressible vessel
• Subacute bacterial endocarditis or acute pericarditis
• Geriatric patients (>75 yr; increased risk of intracranial bleeding)
• Pregnancy, lactation, or children (safety not established).

Exercise Extreme Caution in:

• Patients receiving concurrent anticoagulant therapy (increased risk of intracranial bleeding).

CNS: INTRACRANIAL HEMORRHAGE.

EENT: epistaxis, gingival bleeding.

Resp: bronchospasm, hemoptysis.

CV: reperfusion arrhythmias, hypotension, RECURRENT ISCHEMIA/THROMBOEMBOLISM.

GI: GI BLEEDING, nausea, RETROPERITONEAL BLEEDING, vomiting.

GU: GU TRACT BLEEDING.

Derm: ecchymoses, flushing, urticaria.

Hemat: BLEEDING.

Local: hemorrhage at injection site, phlebitis at injection site.

MS: musculoskeletal pain.

Misc: ALLERGIC REACTIONS INCLUDING ANAPHYLAXIS, fever.

Drug-Drug:

• Aspirin, other NSAIDs, warfarin, heparin and heparin-like agents, abciximab, eptifibatide, tirofiban, clopidogrel, or dipyridamole — concurrent use ↑ risk of bleeding, although these agents are frequently used together or in sequence.
• Effects may be ↓ by antifibrinolytic agents, including aminocaproic acid or tranexamic acid.

Drug-Natural Products:

• ↑anticoagulant effect and bleeding risk with anise, arnica, chamomile, clove, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo, Panax ginseng, licorice, and others.

• Powder for injection: 10.8 units (18.8 mg)/vial;

• IV (Adults): 10 units, followed 30 min later by an additional 10 units.

Retavase

• Directly converts plasminogen to plasmin, which then degrades clot-bound fibrin.

• Lysis of thrombi in coronary arteries, with improvement of ventricular function, and reduced risk of heart failure or death.
• Restoration of cannula or catheter function.
• Restoration of blood flow following lysis of peripheral venous or arterial thrombi.

Therapeutic Classification: thrombolytics

Pharmacologic Classification: plasminogen activators

Absorption: Complete after IV administration. Intracoronary administration or administration into occluded catheters or cannulae has a more localized effect.

Distribution: Unknown.

Metabolism/Excretion: Cleared primarily by the liver and kidneys.

Half-life: 13–16 min.

(fibrinolysis)

• Explain purpose of medication and the need for close monitoring to patient and family. Instruct patient to report hypersensitivity reactions (rash, dyspnea) and bleeding or bruising.
• Explain need for bedrest and minimal handling during therapy to avoid injury. Avoid all unnecessary procedures such as shaving and vigorous tooth brushing.

RE-te-plase

NDC Code^*

• 10122- Chiesi USA, Inc.
  • 10122-141- Retavase
    • 10122-141-02- 1 KIT in 1 BOX (10122-141-02) * 10 mL in 1 VIAL, SINGLE-USE * 10 mL in 1 SYRINGE (10122-142-01)

• 10122- Chiesi USA, Inc.
  • 10122-143- Retavase
    • 10122-143-01- 1 KIT in 1 BOX (10122-143-01) * 10 mL in 1 VIAL, SINGLE-USE * 10 mL in 1 SYRINGE (10122-142-01)