Reteplase

Reteplase is a prescription medication used for the treatment of acute myocardial infarction.

• Reteplase is available under the following different brand names: Retavase

Adult dosage

Powder for injection

• 10.4 units (18.1mg) 

Acute Myocardial Infarction

Adult dosage

• 10 units IV bolus (over 2 minutes), THEN
• Second dose is given 30 minutes after first (for a total cumulative dose of 20 units) 

Dosage Considerations – Should be Given as Follows: 

• See “Dosages"

Common side effects of Reteplase include:

• nausea,
• vomiting,
• fever,
• injection site bleeding,
• blood in the urine,
• bloody or tarry stools,
• stomach pain, or
• vomiting blood or vomit that looks like coffee grounds 

Serious side effects of Reteplase include:

• none

Rare side effects of Reteplase include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Reteplase has severe interactions with the following drugs:
  • defibrotide
  • prothrombin complex concentrate, human 
• Reteplase has serious interactions with the following drugs:
  • apixaban
  • tenecteplase
  • zanubrutinib 
• Reteplase has moderate interactions with at least 77 other drugs.
• Reteplase has minor interactions with the following drug:
  • ceftaroline 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity
• Active bleeding, recent CVA, recent intracranial or intraspinal surgery or trauma, intracranial neoplasm, AVM, aneurysm, bleeding diathesis, severe uncontrolled HTN
• See thrombolytic indications/contraindications 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Reteplase?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Reteplase?”

Cautions

• Recent major surgery, cerebrovascular disease, recent GI or GU bleeding, HTN, acute pericarditis, hemostatic defects, severe thrombophlebitis, severe hepatic/renal dysfunction, currently receiving oral anticoagulants, diabetic hemorrhagic retinopathy, elderly
• Monitor potential bleeding sites
• Cholesterol embolism reported
• Ischemic Stroke: may have no benefit if used after 3 hours of onset
• Current use of warfarin and INR in the high range may increase bleeding risk

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risk during pregnancy

Lactation

• Not known whether the drug crosses into breast milk, unlikely patients will be concerned about nursing in indicated circumstances