Medicines & Supplements A to Z > Alteplase


Last updated on 16/07/2021.

Overview   |   Dosage   |    Side Effects   |   Precautions  |   Tips  |   Where To Buy  




DRUG CLASS: Fibrinolytics

SUB CLASS: Tissue plasminogen activator (tPA)

USED FOR: Acute myocardial infarction, Pulmonary embolism, Acute ischemic stroke

– 20mg, 50mg (injections)

What is Alteplase for?

Alteplase belongs to a class of medications called tissue plasminogen activators (tPA). There are a lot of severe conditions which involve insufficient oxygen to body parts, such as myocardial infarction (a type of heart attack), ischemic stroke (blocked artery in brain), and pulmonary embolism (blocked vessel in lungs). Tissue plasminogen activators can dissolve blood clots quickly to decongest blocked blood vessels. It is considered as an emergency medication for those patients in the hospitals. However, there are contraindications that limit many patients from using Alteplase and other fibrinolytics.

How to use it?

Alteplase is available as injections which will be injected into a vein in hospitals.

Acute myocardial infarction (90-minute regimen):
Adult patients ≤ 67kg:
15 mg intravenous bolus, followed by infusions of 0.75 mg/kg for 30 minutes, then 0.5mg/kg over 1 hour. The total maximum dose is 100 mg.
Adult patients > 67kg:
15 mg intravenous bolus, followed by infusions of 50 mg for 30 minutes, then 35 mg over 1 hour. The total maximum dose is 100 mg.

Acute myocardial infarction (3-hour regimen):
Adult patients < 65kg:
0.075 mg intravenous bolus, followed by infusions of 0.675 mg/kg for the remainder of the first hour, then 0.25 mg/kg the second hour, then 0.25 mg/kg the third hour. The total maximum dose is 100 mg.
Adult patients ≥ 65kg:
6-10 mg intravenous bolus, followed by infusions of 50-54 mg for the remainder of the first hour, then 20 mg the second and third hours. The total maximum dose is 100 mg.

Pulmonary embolism
100 mg infused over 2 hours.

Acute ischemic stroke:
It must be administered within 3-4.5 hours of symptoms onset. After ensuring all eligibility criteria are met, administer 0.9 mg/kg for 60 minutes, up to a maximum of 90 mg.

What are the side effects of Alteplase?

Common side effects of Alteplase include allergic reaction and bleeding.

Who should not take Alteplase?

– People who are allergic to Alteplase or any component in the formulation
– People with a prior ischemic stroke or severe head trauma within 3 months
– Patients with bleeding disorder
– People with gastric bleeding within 1 month
– Patients with history of intracranial or spinal surgery within 3 months
– Patients with current intracranial bleeding

Pharmacist Tips:

– This drug may cause you to bleed more easily, so best to avoid injury. Also report any signs of unusual bleeding, such as bruising, non-stop nose bleeding, or coughing blood.
– Patients with acute myocardial infarction, pulmonary embolism, acute ischemic stroke often require taking other medications to prevent blood clotting and other cardiovascular events for long term.

Common dosing schedule:

This schedule is for reference only, adjustments may be made according to individual needs.

Some common medications Alteplase may interact with:
– Angiotensin-converting enzyme inhibitors, e.g. Captopril, Lisinopril
– Anticoagulants, e.g. Warfarin, Edoxaban, Dabigatran
– Antiplatelets, e.g. Dipyridamole, Aspirin, Clopidogrel
– Nonsteroidal anti-inflammatory drugs, e.g. Ibuprofen, Diclofenac
– Selective serotonin reuptake Inhibitors (SSRIs), e.g. Fluoxetine

Please notify your doctor or pharmacist if you are taking the above medication, dosage adjustments might be needed.

Where to buy Alteplase in Hong Kong?

In Hong Kong, Alteplase is a prescription only medicine, and requires a prescription from a doctor to be purchased in a pharmacy. It can also be obtained from doctors. To find a pharmacy near you, refer to the list of pharmacies (“Authorized Sellers of Poisons”) from the Hong Kong Department of Health.

For more information about drug names and ingredients, you can visit Hong Kong’s Drug Office at

Need more information?

For detailed information about the use of Alteplase in children, pregnancy and breastfeeding, and for questions about drug interactions, please check with your pharmacist or doctor.

Disclaimer: our goal is to provide you with the most relevant drug information and common dosage for Hong Kong. This information does not constitute medical advice. For specific treatment recommendations and advice, always discuss with your doctor or pharmacist, and follow the instructions included with your specific medicine.