Alteplase
Alteplase is a thrombolytic medication, also known as a 'clot-busting' drug, used to dissolve dangerous blood clots in the body. It works by activating plasminogen to plasmin, which breaks down fibrin in clots. This medication is primarily used in emergency situations such as acute heart attacks, ischemic strokes, and pulmonary embolisms to restore blood flow and prevent tissue damage.
Alteplase is an emergency clot-dissolving medication used to treat life-threatening blood clots in the heart, brain, and lungs.
Key facts at a glance
- ATC
- B01AD02
- RxNorm
- 8410
- Generic
- Alteplase
- Class
- atc-b01
- Brands
- Activase
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
9 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second third trimesteruse lowest effective dose
use only when benefits clearly outweigh risks
close maternal and fetal monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedingno adjustment needed
temporarily discontinue breastfeeding for 24 hours after administration
monitor infant for bleeding
Use with caution and monitor for adverse effects.
geriatric
elderly 65 yearsconsider lower dose based on weight and indication
use with caution due to increased bleeding risk especially intracranial hemorrhage
close neurological monitoring blood pressure monitoring
Use with caution and monitor for adverse effects.
pediatric_age
children under 18no standard pediatric dosing established
use only in life-threatening situations such as catheter clearance when benefits outweigh risks
careful bleeding monitoring
renal_impairment
mild to moderateno dose adjustment typically required
use with caution due to increased bleeding risk
monitor renal function and for signs of bleeding
Use with caution and monitor for adverse effects.
renal_impairment
severeuse with extreme caution
weigh risks versus benefits carefully
intensive bleeding monitoring
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderateno specific dose adjustment but use cautiously
use with caution due to altered metabolism and bleeding risk
monitor liver function and coagulation parameters
Use with caution and monitor for adverse effects.
hepatic_impairment
severeavoid if possible
avoid use in severe hepatic impairment due to high bleeding risk
close monitoring if use unavoidable
Use of this medication in this population requires careful consideration of risks and benefits.
Statistics and clinical data
FDA approval year
FDA approval for acute myocardial infarction
Drug class
Tissue-type plasminogen activator (tPA)
Common uses
Thrombolytic therapy for clot dissolution
Mechanism of action
Fibrinolytic action
Treatment of acute myocardial infarction (heart attack), acute ischemic stroke (within 4.5 hours of symptom onset), acute massive pulmonary embolism, and acute peripheral arterial occlusion. It is used in hospital settings for time-sensitive clot-related emergencies.
Alteplase is a recombinant tissue plasminogen activator (tPA) that binds to fibrin in blood clots and converts plasminogen to plasmin. Plasmin then degrades fibrin, breaking down the clot and restoring blood flow to affected tissues.
Administered intravenously, typically within strict time windows depending on the condition. Major risk is bleeding, especially intracranial hemorrhage. Contraindicated in active bleeding, recent surgery, history of hemorrhagic stroke, or uncontrolled high blood pressure. Requires careful patient selection and monitoring. Efficacy depends on time from clot formation—earlier administration yields better outcomes.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy