Which agents are used in thrombolytic therapy?

Updated: Aug 04, 2021
  • Author: Wanda L Rivera-Bou, MD, FAAEM, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Alteplase is the only lytic agent currently approved by the US Food and Drug Administration (FDA) for AMI, AIS, massive PE, and occluded central venous access devices (CVADs). Additional agents and different dosing regimens are under constant investigation. The choice of a lytic agent must be based both on the results of ongoing clinical trials and on the clinician’s experience. The most appropriate agent and regimen for each clinical situation will change over time and may differ from patient to patient.

The information presented in this article is based on clinical and investigational experience as reported in the current literature to the authors’ best knowledge, without respect to FDA approval for a particular indication. Where the literature does not suggest an effective dose for a lytic agent in a particular clinical setting, no dose information is presented. Currently available agents include the following:

  • Alteplase
  • Reteplase
  • Tenecteplase
  • Urokinase
  • Prourokinase
  • Anisoylated purified streptokinase activator complex (APSAC; anistreplase)
  • Streptokinase

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