classesThrombolytics

    Thrombolytics: Uses, most common brand names, and safety information

    Jamie Winn, PharmD
    ✅ Medically reviewed by  Jamie Winn, PharmD

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    Blood clots affect people from all walks of life and many lives are lost because of them. On average, 274 people in the United States die every day from blood clots. They are the main cause of cardiovascular events such as ischemia, heart attack, and stroke. Blood clots that develop in your legs can break free in your leg and travel to your lungs. This can block the blow flow to your lungs and cause a pulmonary embolism.

    Thrombolysis uses medications (thrombolytics) or a minimally invasive procedure called a thrombectomy to break up or remove blood clots. Here we will discuss in more depth the properties, brand names, pricing, and safety of thrombolytics.

    The list below includes FDA-approved thrombolytics and their pricing:

    List of Thrombolytics

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    What are thrombolytics?

    Thrombolytics (fibrinolytic therapy) are clot-busting medications that break up (lysis) and dissolve arterial and venous thromboembolisms (blood clots) that can block blood flow. They may be administered through an intravenous (IV) infusion or through a catheter that delivers the drug directly to the blockage. Your doctor may also physically break the clot with a mechanical device in a procedure called catheter-directed thrombolysis. Thrombolytic therapy is typically an emergency treatment used to save lives and prevent permanent damage to your major organs. There are three major classes of thrombolytic agents and each dissolves clots differently. They include recombinant tissue plasminogen activator (rt-PA), streptokinase, and urokinase fibrinolytic drugs. Streptokinase and urokinase are no longer available in the United States.

    What is the mechanism of action of thrombolytics?

    When blood clots are formed, activated platelets convert prothrombin to thrombin. Thrombin then helps convert fibrinogen into fibrin which can eventually clump together and form a thrombus (blood clot). This process is regulated by plasmin, which is the active form of plasminogen. Plasmin accumulates in the blood clot to help your body break down fibrin to dissolve the clot. Thrombolytic medications work by activating plasminogen to plasmin which disrupts and breaks up the blood clot. This leads to increased blood flow and oxygen, limiting tissue damage. It can also lead to an increased risk of bleeding, which is the main adverse reaction to thrombolytics.

    What conditions are thrombolytics used to treat?

    Thrombolytics are used to treat:

    • Acute myocardial infarction (heart attack)
    • Deep vein thrombosis (DVT)
    • Acute pulmonary embolism (PE)
    • Ischemic stroke
    • Blockage (occlusion) of your peripheral artery
    • Blockage of an indwelling catheter

    Are thrombolytics safe?

    The use of thrombolytics is relatively safe and effective when taken as prescribed. Before beginning treatment with thrombolytics, tell your healthcare provider if you have any of the following:

    • History of uncontrolled hypertension
    • Received CPR for longer than 10 minutes or had major surgery within the past 3 weeks
    • History of ischemic stroke
    • Dementia
    • Internal bleeding
    • Pregnant
    • Stomach ulcer

    What are some common side effects of thrombolytics?

    The adverse effects you experience from thrombolytics will depend on several factors including the medication and dose. Some major side effects of thrombolytics seen in clinical trials include:

    • Major bleeding and severe blood loss
    • Kidney impairment
    • Internal bleeding
    • Severely high blood pressure
    • Bruising
    • Blood vessel damage
    • Increased risk of infection
    • Serious, life-threatening allergic reactions
    • Reperfusion arrhythmias, which occur after blood flow has been restored to your heart

    This is not a complete list of side effects and we encourage you to consult with your healthcare professional for medical advice about any possible side effects.

    What are some contraindications of thrombolytics?

    Thrombolytics should be avoided if you have:

    • Active bleeding or severe blood loss
    • Coronary artery disease
    • Recent major injury or surgery
    • Bleeding disorders
    • Severe stomach ulcer
    • Pregnant
    • Recently used anticoagulants such as warfarin, heparin
    • History of a brain hemorrhage (bleeding)
    • Brain aneurysm or cancer
    • Uncontrolled, severe high blood pressure
    • Severe kidney disease

    What are some drug interactions with thrombolytics?

    The use of thrombolytics with certain foods or medications can affect how they work or increase the frequency and severity of side effects. Make sure your healthcare provider is aware of all the over-the-counter and prescription medications you are taking, including medications that affect coagulation.

    How long does it take thrombolytics to dissolve a blood clot?

    Most thrombolytics can dissolve a small blood clot within a few hours, but it may take up to 48 hours to remove a severe blockage.

    What is the most common complication of thrombolytics?

    The main major complication of thrombolytic medications is internal bleeding. About 5% of patients who take thrombolytics have major bleeds and about 1% have brain bleeds that can cause a stroke.

    What are the most common thrombolytic medications?

    The most common thrombolytic agents available in the United States include:

    How quickly do you have to give a thrombolytic after a stroke?

    Thrombolytic therapy is the treatment of choice for acute stroke, according to the American Heart Association. It should be given within 3 hours after symptoms start to be effective. Treatment after 3 hours was not effective in any clinical trial.

    What is the difference between thrombolytic drugs, antiplatelets, and anticoagulants?

    Anticoagulants prevent clots from forming that block the circulation of blood. Antiplatelets prevent platelets from clumping together to form a clot. Thrombolytics attack and dissolve blood clots that have already formed.

    How much do thrombolytics cost?

    Thrombolytics are very expensive with an average cost of around $10,000 per year.

    You can purchase Thrombolytics for $49 per month from NiceRx if eligible for assistance. Prices at the pharmacy vary by location, strength, and quantity, as well as your insurance status.

    Related resources for thrombolytics

    The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.