Abciximab
Severe
Database
.
Source: DDInter
Drug reference
Reteplase
Recombinant tissue plasminogen activator variant (fibrinolytic) · Antithrombotic
Also known as RETAVASE
START
10 U IV bolus over 2 min, repeat 10 U IV bolus 30 min later
TYPICAL MAX
Total 20 units (two boluses 30 min apart)
STOP IF
Intracranial bleed signs, severe hypotension, or major haemorrhage
WATCH
Neuro status, BP, bleeding, ECG (reperfusion arrhythmias)
CDSCO approvedATC B01AD07
KDIGO 2024 + manufacturer label
- ONSET
- 3min · fibrinolysis
- PEAK
- 30min · post-bolus
- t½
- 15min · t½ ~15 min
- DURATION
- 2h · fibrinolytic
EXCRETION
Hepatic predominant; rapid clearance
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Use only in life-threatening STEMI; benefit outweighs risk.
FDA category + note
Top interactionssee all 12 →
- AbciximabSevereDatabaseDDInter
- AcalabrutinibSevereDatabaseDDInter
- AnisindioneSevereDatabaseDDInter
- ApixabanSevereDatabaseDDInter
Mechanism
Recombinant non-glycosylated deletion mutant of human tPA lacking the kringle-1, finger and EGF domains — binds fibrin less avidly than alteplase but with longer plasma half-life; activates plasminogen to plasmin → fibrin-selective clot lysis.
Indications
Acute ST-elevation myocardial infarction (STEMI — within 12 h)
Dosing
- Adult
- 10 units IV bolus over 2 min, followed by a second 10-unit IV bolus 30 min later.
- Pediatric
- Not established.
- Renal adjustment
- No specific adjustment.
- Hepatic adjustment
- No specific adjustment; bleeding risk in severe disease.
- Geriatric
- No dose change; higher ICH risk — risk-assess.
- Max dose
- Total 20 units (two boluses of 10 units, 30 min apart)
Pharmacokinetics
Onset
Fibrinolysis within minutes
Peak effect
Within 30 min of bolus
Duration
Fibrinolytic effect ~1 h; clotting recovers hours
Half-life
~13–16 min
Bioavailability
IV 100%
Protein binding
Not applicable
Metabolism
Hepatic / renal proteolysis
Excretion
Hepatic predominant; rapid clearance
Contraindications
- Active internal bleeding
- Recent (≤3 months) intracranial haemorrhage / stroke / major trauma / surgery
- Known intracranial neoplasm / AVM / aneurysm
- Severe uncontrolled hypertension (>180/110)
- Bleeding diathesis
- Hypersensitivity
Side effects
Common
Bleeding (puncture sites, GI)HypotensionNauseaReperfusion arrhythmias
Serious
- Intracranial haemorrhage
- Major systemic haemorrhage
- Cardiac tamponade (cardiac rupture)
- Cholesterol embolisation
Pregnancy & lactation
Pregnancy
Use only in life-threatening STEMI; benefit outweighs risk.
Lactation
No data; brief interruption reasonable.
Drug interactions
Acalabrutinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Anisindione
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Apixaban
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Ardeparin
Severe
Database
Clinical effect not specified
Source: DDInter
Argatroban
Severe
Database
Clinical effect not specified
Source: DDInter
Avapritinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Betrixaban
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bivalirudin
Severe
Database
Clinical effect not specified
Source: DDInter
Cabozantinib
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Cangrelor
Severe
Database
Clinical effect not specified
Source: DDInter
Caplacizumab
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Ask House about Reteplase
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Harrison 22e, Katzung·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20