Determining the Accelerated Infusion Dose of Alteplase for Thrombolysis in Acute Myocardial Infarction

 

It is supplied in 50 and 100 mg vials reconstituted with sterile water for injection to 50 and 100 mL respectively, giving a dose of 1 mg per mL. Each mg of alteplase has an activity of 580,000 IU (WHO).

 

The dose is determined by the patient's body weight. The maximum dose is 100 mg. It should be given within 4 hours after the myocardial infarction.

 

Administration is in 3 phases:

(1) 15 mg is administered as an intravenous bolus over 1 minute.

(2) Approximately 60% of the remaining dose is infused over the next 30 minutes.

(3) The remainder of the dose is infused over the following 60 minutes.

Infusion Phase	Dose for Patients with Body Weight <= 67 kg	Dose for Patients with Body Weight > 67 kg
Phase 2	0.75 mg/kg body weight	50 mg
Phase 3	0.50 mg/kg body weight	35 mg

 

where:

• It is not stated that lean body weight should be used for the calculations.