Reconstitute Activase® (alteplase) immediately before administration and monitor patients

Review these general guidelines for Activase reconstitution

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 bolus over 1 minute. 5

Activase® (alteplase) 100mg

Follow the steps below for reconstituting 100-mg vials. 5

  • Reconstitute Activase immediately before administration, using only Sterile Water for Injection (SWFI) U.S. Pharmacopeia (USP) without preservatives as well as the transfer device. Both are provided in the Activase package. Do not use Bacteriostatic Water for Injection, USP.
  • Begin by assembling the Activase vial; the vial of SWFI, USP; 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.
Activase® (alteplase) 100mg kit
  • Reconstitution should be carried out using the transfer device provided and by 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 technique at all times.
Step 1:

Remove protective caps and swab the top of each vial with an alcohol wipe to reduce the risk of contamination.

REMOVE CAPS
Activase® (alteplase) 100mg cap removal
STERILIZE
Activase® (alteplase) sterilize
Step 2:

Remove one of the protective caps from the transfer device and insert the piercing pin vertically into the center of the stopper of the SWFI vial, keeping the vial upright. Holding the Activase vial upside down, position it so that the center of the stopper is directly over the exposed pin of the transfer device. Push vial down onto the transfer device, ensuring that the piercing pin is inserted through the center of the Activase vial stopper.

INSERT TRANSFER PIN IN SWFI VIAL
Activase® (alteplase)
INSERT ACTIVASE VIAL ON OTHER END OF PIN
Activase® (alteplase)
PUSH DOWN
Activase® (alteplase)
Step 3:

Invert the 2 vials, so that the vial of Activase is on the bottom (upright) and the vial of SWFI is upside down. Allow the entire contents of the vial of SWFI to flow down through the transfer device into the vial containing Activase. Approximately 0.5 mL of SWFI will remain in the diluent vial. 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.

INVERT VIALS
DISCARD PIN AND SWFI VIAL
Step 4:

Mix the solution with a gentle swirl. 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. This preparation will result in a colorless to pale yellow transparent solution containing Activase at a concentration of 1 mg/mL. Visually inspect the Activase solution for particulate matter and discoloration before administration.

MIX GENTLY
LET IT SETTLE (SEVERAL MINUTES)
INSPECT SOLUTION

The solution may be used for intravenous administration within 8 hours following reconstitution when stored between 2-30°C (36-86°F). Do not add other medication to solutions containing Activase. Any unused solution should be discarded.

During and following Activase administration for the treatment of AIS, frequently monitor and control blood pressure.

In patients without recent use of oral anticoagulants or heparin, Activase treatment can be initiated prior to the availability of coagulation study results. Discontinue Activase if the pretreatment International Normalized Ratio (INR) is greater than 1.7 or the activated partial thromboplastin time (aPTT) is elevated.

Learn how to dose and administer Activase >

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