Urokinase

Urokinase is a prescription medication used to treat blood clots in the lungs. 

• Urokinase are available under various brand names: Abbokinase, Kinlytic

Common side effects of Urokinase include:

• easy bruising, and
• bleeding

Serious side effects of Urokinase include:

• hives,
• difficult breathing,
• swelling of the face, lips, tongue, or throat.
• risk of bleeding,
• easy bruising or bleeding (nosebleeds, bleeding gums, bleeding from a wound, incision, catheter, or needle injection);
• bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
• red or pink urine; or
• sudden numbness or weakness (especially on one side of the body), sudden severe headache, slurred speech, problems with vision or balance,
• chest pain or heavy feeling, pain spreading to the jaw or shoulder, nausea, sweating, general ill feeling;
• swelling, rapid weight gain, little or no urinating;
• severe stomach pain, nausea, and vomiting;
• darkening or purple discoloration of your fingers or toes;
• very slow heartbeats, shortness of breath, feeling light-headed;
• sudden severe back pain, muscle weakness, numbness or loss of feeling in your arms or legs;
• dangerously high blood pressure--severe headache, blurred vision, pounding in your neck or ears, nosebleed, anxiety, confusion, severe chest pain, shortness of breath, irregular heartbeats; or
• pancreatitis--severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate.

Rare side effects of Urokinase include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors.
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

• Sterile lyophilized white powder
• 250,000 international units urokinase per vial

Pulmonary embolism

Adult and pediatric dosage

• The loading dose of 4,400 international units per kilogram of urokinase injection is given at a rate of 90 mL per hour over a period of 10 minutes.
• This is followed with a continuous infusion of 4,400 international units per kilogram per hour at a rate of 15 mL for 12 hours.
• Administration of urokinase injection may be repeated as necessary.
• A dosing and preparation chart for patients who weigh 37 to 114 kilograms (81 to 250 pounds) is provided as a guide in the Preparation Section that follows below. If the patient is outside of these weights, calculate with dosing information provided above.

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

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.

• Urokinase has severe interactions with the following drugs:
  • a blood thinner (heparin, warfarin, Coumadin, Jantoven);
  • NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others; or
  • medication used to prevent blood clots--abciximab, eptifibatide, tirofiban, vorapaxar.
• Urokinase has serious interactions with no other  drugs.
• Urokinase has moderate interactions with no other drugs.
• Urokinase has minor interactions with no other drugs.

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

• allergic reaction to urokinase
• active bleeding inside your body;
• a brain tumor or blood vessel disorder;
• a brain aneurysm (dilated blood vessel);
• a bleeding or blood clotting disorder (such as hemophilia);
• severe or uncontrolled high blood pressure;
• if you have had a recent medical emergency requiring CPR (cardiopulmonary resuscitation); or
• if you have had a stroke, brain surgery, or spinal surgery within in the past 2 months.

Effects of drug abuse

• None

Short-Term Effects

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

Long-Term Effects

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

Cautions

• If possible before you receive urokinase, tell your doctor if you have a brain tumor or aneurysm, hemophilia or other bleeding disorder, high blood pressure, or if you have recently had a stroke, brain or spinal surgery, or medical emergency requiring CPR (cardiopulmonary resuscitation).
• In an emergency situation it may not be possible to tell your caregivers about your health conditions. Make sure any doctor caring for you afterward knows you have received this medicine..
• Ask your doctor before taking aspirin or ibuprofen (Motrin, Advil) shortly after you have received urokinase. These medications can increase your risk of bleeding.
• Avoid activities that may increase your risk of bleeding or injury. Use extra care to prevent bleeding while shaving or brushing your teeth.
• Urokinase is made from human plasma (part of the blood) which may contain viruses and other infectious agents. Donated plasma is tested and treated to reduce the risk of it containing infectious agents, but there is still a small possibility it could transmit disease. Talk with your doctor about the risks and benefits of using this medication.

Pregnancy and Lactation

• Reproduction studies have been performed in mice and rats at doses up to 1,000 times the human dose and have revealed no evidence of impaired fertility or harm to the fetus due to urokinase injection. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
• Lactation
  • It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when urokinase injection is administered to a nursing woman.