Log In to Order Resources
| Register >
|  
Shopping Cart
Home > Activase for Acute Ischemic Stroke > Activase Dosing and Administration

Before you start exploring, please read the Important Safety Information.

Download Full Prescribing Information

Activase Dosing and Administration

The recommended dose of Activase is 0.9 mg/kg (not to exceed 90-mg total dose) infused over 60 minutes with 10% of the total dose administered as an initial intravenous (IV) bolus over 1 minute.

Reconstitution of 100-mg Vials

Reconstitution of 100-mg Vials

100-mg Vials Video

Begin by assembling the Activase vial, the vial of Sterile Water for Injection (SWFI), USP (included with the Activase package), and the transfer device included in the Activase package. Also, gather alcohol swabs and 2 syringes: 1 for the bolus dose and 1 for the discarded quantity of Activase.

Reconstitution should be carried out using the transfer device provided and adding the contents of the 100-mL vial of SWFI to the 100-mg vial of Activase powder. Reconstitute Activase immediately before administration, using aseptic techniques at all times—including thorough hand washing and the use of gloves.

  • Step 1:

    Remove the protective cap from the top of the Activase vial and the vial of SWFI. Swab the top of each vial with an alcohol wipe to reduce the risk of contamination

  • Step 2:

    Remove the transfer device from its wrapper and remove the protective cap from one end. Insert the piercing pin vertically into the center of the stopper of the vial of SWFI, keeping the vial upright

  • Step 3:

    Remove the protective cap from the other end of the transfer device. Holding the vial of Activase upside down, position it so that the center of the stopper is directly over the exposed pin of the transfer device

  • Step 4:

    Push the vial of Activase down onto the transfer device, making sure that the piercing pin is inserted through the center of the Activase vial stopper

  • Step 5:

    Invert the 2 vials, so that the vial of Activase is on the bottom, right side up, and the vial of SWFI is on top. Allow the entire contents of the vial of SWFI to flow down through the transfer device into the vial containing Activase—a process that requires approximately 2 minutes. About half a milliliter of Sterile Water may remain in the upper vial. DO NOT USE Bacteriostatic Water for Injection, USP

  • Step 6:

    Remove the transfer device and the empty SWFI vial from the Activase vial. Safely discard both the transfer device and the empty diluent vial according to institutional procedures

  • Step 7:

    Mix the solution with a gentle swirl or slow inversion. DO NOT SHAKE. Slight foaming of the solution is normal. Let the solution stand undisturbed for several minutes to allow any large bubbles to dissipate. Visually inspect the Activase solution for particulate matter and discoloration before administration

Activase is stable for up to 8 hours in these solutions at room temperature. Do not freeze solutions containing Activase. No other medications should be added to infusions containing Activase. Any unused infusion solution should be discarded.

Reconstitution of 50-mg Vials

Reconstitution of 50-mg Vials

50-mg Vials Video

A single 50-mg vial of Activase may be used to treat patients weighing up to 122 lbs or 55.5 kilograms. Reconstitute Activase immediately before administration, using aseptic technique at all times—including thorough hand washing and the use of gloves.

  • Step 1:

    Assemble the 50-mg vial of Activase, the vial of Sterile Water for Injection (SWFI), USP (included with the Activase package), a 50-mL syringe, a large-bore needle (eg, 18-gauge), and alcohol wipes. Also, prepare a polyvinyl chloride bag or glass vial along with an infusion set

  • Step 2:

    Remove the protective cap from the top of the Activase vial and the vial of SWFI. Swab the top of each vial with an alcohol wipe to reduce the risk of contamination

  • Step 3:

    Withdraw 50-mL of SWFI, without preservatives. Diluent is included. DO NOT USE Bacteriostatic Water for Injection, USP

  • Step 4:

    Inject the 50-mL into the 50-mg Activase vial using a large-bore needle and syringe, directing the stream into the lyophilized cake. DO NOT USE IF VACUUM IS NOT PRESENT. The syringe should not be primed with air during preparation and should be inserted into the Activase vial stopper. Slight foaming upon reconstitution is normal. Let the solution stand undisturbed for several minutes to allow any large bubbles to dissipate

  • Step 5:

    Mix with a gentle swirl or slow inversion. DO NOT SHAKE. Visually inspect the Activase solution for particulate matter and discoloration before administration

Activase is stable for up to 8 hours in these solutions at room temperature. Do not freeze solutions containing Activase. No other medications should be added to infusions containing Activase. Any unused infusion solution should be discarded.

Activase Administration

Administration of bolus

  • Step 1:

    Discard excess
    To ensure proper dosing, discard excess by removing from vial any quantity of drug in excess of that specified for patient treatment. When drawing off excess solution, be sure to insert the needle into the peripheral area of the vial top, away from the puncture site caused by the transfer device

  • Step 2:

    Prepare bolus
    Withdraw 10% of the 0.9-mg/kg dose in one of the following ways:

    • Remove from vial using a syringe and needle,
    • Remove from port (second injection site) on infusion line after infusion set is primed, or
    • Program infusion pump to deliver bolus at infusion initiation. Remember to prime the intravenous (IV) pump with the Activase solution so that the remainder of the infusion begins immediately following the bolus dose
  • Step 3:

    Administer bolus
    Administer initial IV bolus over 1 minute

Administration of remainder of dose

Infuse the remaining 90% of 0.9-mg/kg dose over 60 minutes.

100-mg vials—Insert the spike end of an infusion set through the same puncture site created by the transfer device in the stopper of the vial of reconstituted Activase. Peel the clear plastic hanger from the vial label. Hang the Activase vial from the resulting loop.

Activase can also be administered by programming an infusion pump. Remember to prime the IV pump tubing with the Activase solution so that the infusion begins immediately following the bolus dose.

Because IV pumps and tubing vary, a standardized procedure should be initiated at each hospital to ensure delivery of the full Activase dose, including the volume of Activase in the IV tubing. One possible solution is to spike a small bag (eg, 50-mL) of 0.9% Sodium Chloride Injection, USP, with the end of the Activase infusion set when the Activase vial is empty. The infusion should continue at the same rate to ensure that all the Activase remaining in the tubing is received by the patient.

No medication should be added to the infusion solutions that contain Activase.

50-mg vials—Administer using either a polyvinyl chloride bag or glass vial and infusion set.

Resources

Resources are available to help you with the dosing and administration of Activase in acute ischemic stroke.

Activase Dosing Card
Activase Dosing Card
Useful card to help you properly administer Activase for acute ischemic stroke.
Order Quantity:
Dosing and Administration Poster
(25 posters per order)
Share with others the proper technique to administer Activase for acute ischemic stroke.
Order Quantity:
If you have ordered materials, please add to cart. Add to Cart

Education and Training

HealthStream

Free access to educational materials and training on acute ischemic stroke and Activase for your stroke center. 

Learn More

Dosing and Administration

Dosing Vial

View videos and instructions for the appropriate dosing and administration of Activase for acute ischemic stroke.

View Now

Register for Updates

Educational Resources

Receive updates and gain free access to order educational resources.

Register Now

Already registered?
Log In >

Acute Ischemic Stroke Indication

Activase is indicated for the management of acute ischemic stroke in adults for improving neurological recovery and reducing the incidence of disability. Treatment should only be initiated within 3 hours after the onset of stroke symptoms, and after exclusion of intracranial hemorrhage by a cranial computerized tomography (CT) scan or other diagnostic imaging method sensitive for the presence of hemorrhage (see CONTRAINDICATIONS in the full prescribing information).

Acute Massive Pulmonary Embolism Indication

Activase is indicated in the management of acute massive pulmonary embolism (AMPE) 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.

Important Safety Information

CONTRAINDICATIONS

Acute Ischemic Stroke (AIS):

  • Treatment should only be initiated within 3 hours after the onset of stroke symptoms, and after exclusion of intracranial hemorrhage by a cranial computerized tomography (CT) scan or other diagnostic imaging method sensitive for the presence of hemorrhage [See CONTRAINDICATIONS in the full prescribing information].
  • Activase therapy in patients with AIS is contraindicated in certain situations (eg, suspicion of subarachnoid hemorrhage on pretreatment evaluation), recent (within 3 months) intracranial or intraspinal surgery, history of intracranial hemorrhage, uncontrolled hypertension at time of treatment, active internal bleeding, known bleeding diathesis (eg, current use of oral anticoagulants, administration of heparin within 48 hours of onset of stroke, platelet count <100,000/mm3) [See CONTRAINDICATIONS in the full prescribing information].

Pulmonary Embolism (PE):

  • Activase therapy in patients with PE is contraindicated in certain situations (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].

WARNINGS

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 the full prescribing information].

Acute Ischemic Stroke (AIS):

  • Patients with severe neurological deficit (eg, NIHSS >22) at presentation. There is an increased risk of intracranial hemorrhage in these patients.
  • Patients with major early infarct signs on a computerized cranial tomography (CT) scan (eg, substantial edema, mass effect, or midline shift).

Treatment of patients with minor neurological deficit or with rapidly improving symptoms is not recommended [See WARNINGS in the full prescribing information].

Pulmonary Embolism (PE):

  • 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.

PRECAUTIONS (AIS)

Orolingual angioedema has been observed in postmarketing experience in patients treated with Activase for AIS. Patients should be monitored during and for several hours after infusion for signs of orolingual angioedema.

ADVERSE REACTIONS

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. Death and permanent disability are not uncommonly reported in patients who have experienced stroke (including intracranial bleeding) and other serious bleeding episodes.

activase-prescribing-information
close

You are now leaving Activase.com

The link you have selected will take you away from this site to one that is not owned or controlled by Genentech. Genentech makes no representation as to the accuracy of the information contained on sites it does not own or control. Genentech does not recommend and does not endorse the content on any third-party websites. Your use of third-party websites is at your own risk and subject to the terms and conditions of use for such sites.

Continue Return to Site
<% string shareurl="../home/index.jsp" session.removeattribute("shareend"); if(shareurl.equals("")) { ; } %> close

Thank You! An Email Has Been Sent to:

<% string emails="request.getSession().getAttribute("sentTo").toString();" ; if(request.getsession().getattribute("sentto") !="null)" %> <% emails %>


Return

close

Please Log In or Register Now

Registered User Login

Username:


Password:


Forgot your password?
Click here

Log In

Not a Registered User?

Register now to order free resources and receive updates.

Register Now <%if(isshoppingcart && (cart.itemsincart() !="0))" {%>
Items in your cart
<% cart.itemsincart() %>
<%} %>
close

Thank You for Registering!

Continue

close
close

Browser Advisory


We recommend you use Internet Explorer 9 or higher, or the most current version of Firefox, Safari, or Google Chrome. If you have a previous version of one of these browsers you can download a free copy of the latest version from Microsoft, Firefox, Apple, or Google, or contact your technical support for assistance.

Close