Alteplase (Activase, Genentech) is a recombinant tissue plasminogen activator that can be used for thrombolysis in patients with acute myocardial infarction. This may administered as an accelerated (given over 90 minutes) or 3 hour (180 minute) infusion


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



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


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