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Activase (Alteplase) for acute massive pulmonary embolism (PE)

  • Pulmonary embolism remains common, underdiagnosed, and potentially lethal1
  • PE occurs in at least 650,000 patients annually in the United States2
  • Acute massive PE is defined as:
    • – >50% occlusion of pulmonary vasculature3
    • – Unstable hemodynamics defined by failure to maintain BP without supportive measures
  • Activase (t-PA) is considered the standard treatment for eligible patients with acute massive PE and is recommended by ACCP & ACEP guidelines4

Connect to guidelines from professional associations

Genentech is neither affiliated with nor endorses the organizations listed above.

Important safety information

Activase (t-PA) therapy in patients with pulmonary embolism is contraindicated in the following situations because of an increased risk of bleeding, which could result in significant disability or death:

  • Active internal bleeding
  • History of cerebrovascular accident
  • Recent intracranial or intraspinal surgery or trauma (see WARNINGS in full prescribing information)
  • Intracranial neoplasm, arteriovenous malformation, or aneurysm
  • Known bleeding diathesis
  • Severe uncontrolled hypertension
  • ACCP=American College of Chest Physicians.
  • ACEP=American College of Emergency Physicians.


Pulmonary embolism materialsFor additional information regarding Activase (t-PA) and the treatment of acute massive PE, please see the resources listed below:

  • "Activase® (t-PA) in Acute Massive Pulmonary Embolism" dosing card
    DOWNLOAD OR ORDER
  • "Fibrinolytics for Acute Massive Pulmonary Embolism" educational CD-ROM
    DOWNLOAD OR ORDER

Indication
Activase (Alteplase) is indicated in the management of acute massive pulmonary embolism (PE) in adults: (1) for the lysis of acute pulmonary emboli, defined as obstruction of blood flow to a lobe or multiple segments of the lungs; (2) for the lysis of pulmonary emboli accompanied by unstable hemodynamics, eg, failure to maintain blood pressure without supportive measures. The diagnosis should be confirmed by objective means, such as pulmonary angiography or noninvasive procedures such as lung scanning.

Safety Information
Activase therapy in patients with pulmonary embolism (PE) is contraindicated in certain situations because of an increased risk of bleeding (eg, active internal bleeding, history of cerebrovascular accident, recent intracranial or intraspinal surgery or trauma, severe uncontrolled hypertension) [See CONTRAINDICATIONS in the full prescribing information].

The most common complication during Activase therapy is bleeding. Should serious bleeding in a critical location (intracranial, gastrointestinal, retroperitoneal, pericardial) occur, Activase therapy should be discontinued immediately, along with any concomitant therapy with heparin.

The risks of Activase therapy for all approved indications may be increased and should be weighed against the anticipated benefits in certain conditions [See WARNINGS in full prescribing information].

Treatment of PE with Activase has not been shown to constitute adequate clinical treatment of underlying deep vein thrombosis. The possible risk of reembolization due to the lysis of underlying deep venous thrombi should be considered.

Please click here for full prescribing information.
References:
1.
Wood KE. Major pulmonary embolism: review of a pathophysiologic approach to the golden hour of hemodynamically significant pulmonary embolism. Chest. 2002;121:877-905.
2.
Sutherland SF. Pulmonary embolism eMedicine Web site. http://www.emedicine.com/emerg/topic490.htm. Updated May 8, 2009. Accessed June 2, 2009.
3.
Tan KT, Oudkerk M, van Beek EJR. Deep vein thrombosis and pulmonary embolism. In: Hallet JW Jr, Mills JL, Earnshaw JJ, Reekers JA, eds. Comprehensive Vascular and Endovascular Surgery. Philadelphia, PA: Elsevier Limited; 2004:625-663.
4.
Kucher N, Goldhaber SZ. Management of massive pulmonary embolism. Circulation. 2005;112:e28-e32.