Streptokinase

Indications
 Intravenous
Acute myocardial infarction
Adult: 1.5 million units as a single dose infused over 1 hr immediately after onset of symptoms.
Intravenous
Pulmonary thromboembolism
Adult: Loading dose: 250,000 units infused over 30 min. Maintenance: 100,000 units/hr for 24-72 hr depending on the condition to be treated. For cerebral retinal thrombosis, 12 hr may be sufficient. Monitor treatment by maintaining thrombin clotting time at 2-4 times normal values.
Child: Loading dose: 2500-4000 units/kg over 30 min, followed by infusion of 500-1000 units/kg/hr, continued until reperfusion occurs, up to 3 days. Initial dose may be estimated by streptokinase resistance test. Monitor treatment by maintaining thrombin clotting time at 2-4 times normal values.
Intravenous
Arteriovenous occlusions
Adult: Loading dose: 250,000 units infused over 30 min. Maintenance: 100,000 units/hr for 24-72 hr depending on the condition to be treated. For cerebral retinal thrombosis, 12 hr may be sufficient. Monitor treatment by maintaining thrombin clotting time at 2-4 times normal values.
Child: Loading dose: 2500-4000 units/kg over 30 min, followed by infusion of 500-1000 units/kg/hr, continued until reperfusion occurs, up to 3 days. Initial dose may be estimated by streptokinase resistance test. Monitor treatment by maintaining thrombin clotting time at 2-4 times normal values.
Contraindications
 Severe hypertension, recent stroke, cerebral neoplasm, recent history of peptic ulcer disease, ulcerative colitis, pancreatitis, subacute bacterial endocarditis, coagulation defects also due to liver or kidney disease, recent surgery, childbirth. Hypersensitivity, increased risk of cerebral bleeding, trauma. Pregnancy. Active internal bleeding, bleeding GI lesions.
Warnings / Precautions
 Mitral stenosis associated with AF. Streptokinase treatment within last 12 mth, use after prolonged or traumatic CPR; diabetic retinopathy. Elderly.
Adverse Reactions
 Fever, chills, back pain, abdominal pain, nausea, vomiting, arrhythmia, bruising, rash, pruritus, acute renal failure due to embolism and haemorrhage. Cerebral, peripheral and pulmonary embolism. Allergic reactions, liver enzyme abnormalities, hypotension.
Potentially Fatal: Haemorrhage; anaphylactic shock.
Drug Interactions
 Antagonistic effects with antifibrinolytic agents e.g. aminocaproic acid.
Potentially Fatal: Anticoagulants, heparin, antiplatelet agents e.g. aspirin and dipyridamole affect platelet function increasing the risk of haemorrhage.
See Below for More streptokinase Drug Interactions
Mechanism of Actions
 Streptokinase forms a complex with plasminogen which then converts plasminogen to plasmin. Plasmin breaks down clots as well as fibrinogen and other plasma proteins.
Absorption: Rapidly cleared from the circulation after IV use.
Excretion: Elimination half-life of streptokinase-activator complex: 23 minutes.
Storage Conditions
 Intravenous: Store unopened vials at room temperature. Reconstituted solutions should be kept in the refrigerator and used within 24 hr after preparation.
ATC Classification
 B01AD01 - streptokinase ; Belongs to the class of enzymes. Used in the treatment of thrombosis.
Storage
 Intravenous: Store unopened vials at room temperature. Reconstituted solutions should be kept in the refrigerator and used within 24 hr after preparation.
Available As
  • Streptokinase 0.75 million iu
  • Streptokinase 1.5 million iu
  • Streptokinase 1.50 million iu
  • Streptokinase 15 lac iu
  • Streptokinase 2.5 million iu

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