Indications
Urokinase is a clot-dissolving (thrombolytic) medicine used in hospital to break down dangerous blood clots, mainly large clots in the lungs (pulmonary embolism). It is also used to clear blocked intravenous catheters and, in some centres, for clots in deep veins or blood vessels of the limbs.
How It Works
Urokinase is an enzyme that converts plasminogen, a protein in the blood, into plasmin. Plasmin breaks down fibrin, the mesh that holds a blood clot together, so the clot dissolves and blood flow can return.
Dosage and Administration
Urokinase is given only in hospital by a doctor or nurse, as an injection or infusion into a vein, or directly into a catheter. The dose depends on the condition being treated and on body weight, and is set by the treating doctor. Patients are closely monitored during and after treatment.
Interactions
The risk of bleeding is higher with other medicines that affect clotting, such as Heparin, Warfarin and other anticoagulants, Aspirin, Clopidogrel and other antiplatelet medicines, and NSAIDs. The medical team will plan how these are used around the treatment.
Contraindications
- Active internal bleeding.
- Recent stroke, or recent brain or spinal surgery or injury.
- Brain tumour, aneurysm or abnormal blood vessels in the brain.
- Severe uncontrolled high blood pressure.
- Known bleeding disorder.
- Allergy to Urokinase.
Side Effects
The main side effect is bleeding, which may be minor (from injection sites or gums, bruising) or serious (inside the stomach, bowel, urinary tract or brain). Fever, chills, nausea, vomiting, changes in blood pressure, back pain and allergic reactions can also occur.
Tell the nurse or doctor at once about sudden severe headache, confusion, weakness or trouble speaking, vomiting blood, black stools, blood in the urine, chest pain, shortness of breath, or swelling of the face or throat.
Pregnancy and Lactation
Use in pregnancy only when the benefit clearly outweighs the risk, because of the risk of bleeding and of separation of the placenta. It is not known whether it passes into breast milk; the doctor will advise on breastfeeding.
Precautions and Warnings
Treatment is given in a monitored setting with blood tests and checks for bleeding. Injections into muscles and unnecessary needle sticks are avoided during treatment. Tell the medical team about recent surgery, childbirth, injuries, ulcers, liver or kidney disease, or any bleeding problems.
Overdose
Too much Urokinase increases the risk of serious bleeding. The infusion is stopped and the medical team gives supportive care, which may include blood products.
Therapeutic Class
Thrombolytic agent (plasminogen activator).
Storage
Store as directed on the pack, usually in a refrigerator at 2 to 8°C; do not freeze. Hospital use only; keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.