UROKINASE

Indications & Dose:

Deep-vein thrombosis (thromboembolic occlusive vascular disease)

• BY INTRAVENOUS INFUSION

Adult: Initially 4400 units/kg, to be given over 10–20 minutes, followed by 100 000 units/hour for 2–3 days

Pulmonary embolism (thromboembolic occlusive vascular disease)

• BY INTRAVENOUS INFUSION

Adult: Initially 4400 units/kg, to be given over 10–20 minutes, followed by 4400 units/kg/hour for 12 hours continuedOcclusive peripheral arterial disease (thromboembolic occlusive vascular disease) l

• BY INTRA-ARTERIAL INFUSION

Adult: (consult product literature)

Occluded central venous catheters (blocked by fibrin clots)  

• BY INTRAVENOUS INJECTION

Adult: Inject directly into occluded catheter, to be dissolved in sodium chloride 0.9% to a concentration of 5000 units/mL; use a volume sufficient to fill the catheter lumen; leave for 20– 60 minutes then aspirate the lysate; repeat if necessary

Occluded arteriovenous haemodialysis shunts (blocked by fibrin clots)

• BY INTRAVENOUS INFUSION, OR BY INTRA-ARTERIAL INFUSION

Adult: (consult product literature)

Pulmonary embolism (thromboembolic occlusive vascular disease)

• INITIALLY BY INTRAVENOUS INFUSION

Adult: Initially 4400 units/kg, to be given over 10 minutes, dose to be made up in 15mL sodium chloride 0.9%, followed by (by intravenous infusion) 4400 micrograms/kg/hour for 12 hours, alternatively (by intra-arterial injection) initially 15 000 units/kg, to be injected into pulmonary artery, subsequent doses adjusted according to response; maximum 3 doses per day

Occlusive peripheral arterial disease l

• BY INTRA-ARTERIAL INFUSION

Adult: (consult product literature)

Occluded intravenous catheters and cannulas (blocked by fibrin clots)

• BY INTRA-ARTERIAL INJECTION, OR BY INTRAVENOUS

INJECTION

Adult: 5000–25 000 units, to be injected directly into catheter or cannula, dose dissolved in suitable volume of sodium chloride 0.9% to fill the catheter or cannula lumen; leave for 20–60 minutes then aspirate the lysate; repeat if necessary

BREAST FEEDING Manufacturer advises avoid— no information available.

HEPATIC IMPAIRMENT Dose reduction may be required.

RENAL IMPAIRMENT Dose reduction may be required.

Contraindications:

Recent bleeding following surgery, cerebrovascular bleeding, severe hypertension, severe hepatic or renal impairment, immediate post-partum period.

Side Effects:

Cautions:

Precautions:

Peptic ulcer or risk of Gl bleeding, recent repeated intravascular or intracardiac puncture, recent cardiopulmonary resuscitation

Interaction:

Warnings:

Adverse Effects:

Local irritation, bleeding and haemorrhagic complications, pyrexia, haematuria, embolic episodes, cholesterol embolism, allergic reactions.

Pregnancy: Contraindicated in pregnancy..

Lactations:

Caution advised or effect undetermined.

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: