Generic
Streptokinase
4 brands available in the market
At a glance
Streptokinase is a thrombolytic used for acute transmural myocardial infarction, deep vein thrombosis, pulmonary embolism, and peripheral arterial thrombosis. It dissolves blood clots by converting plasminogen to plasmin.
Description
Streptokinase forms a 1:1 complex with plasminogen, inducing a conformational change that exposes its active site. This altered plasminogen then converts additional plasminogen molecules to plasmin. Plasmin degrades fibrin clots, fibrinogen, and other plasma proteins, dissolving blood clots.
Indications
- Acute transmural myocardial infarction (within 12 hours)
- Deep vein thrombosis (DVT – within 14 days)
- Acute massive pulmonary embolism (PE)
- Acute and subacute peripheral arterial thrombosis
- Central retinal artery or vein occlusion
Therapeutic class
Fibrinolytics (Thrombolytics)
Pharmacological class
Plasminogen Activator
Pharmacology
Streptokinase forms a complex with plasminogen that converts plasminogen to plasmin. Plasmin degrades fibrin clots, fibrinogen, and other plasma proteins. This dissolves blood clots, restores blood flow, and prevents tissue death.
Mechanism of action
Converts plasminogen to plasmin to dissolve blood clots.
Dosage
Adult Dose (IV):
- Acute MI: 1.5 million units as a single dose over 60 minutes
- PE/Peripheral occlusion: Loading 250,000 units over 30 min; Maintenance 100,000 units/hr for 24-72 hours
Pediatric Dose (IV):
- Loading: 2500-4000 units/kg over 30 min; Infusion: 500-1000 units/kg/hr
Administration
- Administered intravenously by a healthcare professional in a hospital setting
- Do not self-administer
- Use within 8 hours of reconstitution (at 2-8°C)
Missed dose
If you miss a dose, consult your doctor.
Side effects
Serious Side Effects:
- Bleeding (major – 0.2-0.3%; minor – up to 10%)
- Allergic reactions (anaphylactic shock – 0.1%; mild allergy – 2-20%)
- Hypotension, arrhythmias
Precautions & warnings
- Do not use in bleeding disorders, active internal bleeding, recent trauma/surgery, severe uncontrolled hypertension
- Do not use in recent stroke, intracranial neoplasm, subacute bacterial endocarditis
- Caution in pregnancy, age >75 years
Contraindications
- Active internal bleeding
- Recent trauma (head injury, resuscitation)
- Severe uncontrolled hypertension
- Stroke or recent cerebrovascular accident
- Intracranial or intraspinal surgery
- Known allergy to streptokinase
- Previous streptokinase therapy (5 days-12 months)
Drug interactions
- Heparin, anticoagulants, antiplatelets (aspirin, dipyridamole): Increased bleeding risk (potentially fatal)
- Antifibrinolytics (aminocaproic acid): Antagonistic effects
Food interactions
It is not known whether alcohol is safe with Streptokinase; consult your doctor.
Use in pregnancy
Use in Pregnancy: May be unsafe; animal studies show harmful effects; use only if clearly needed; consult your doctor.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Information not available; consult your doctor.
Pediatric use
No controlled clinical studies in children; anecdotal reports available
Geriatric use
Caution in elderly (age >75 years)
Renal / hepatic impairment
Renal Impairment: Safe in kidney disease; dose adjustment may not be needed; do not use in severe kidney disease; consult your doctor.
Hepatic Impairment: Caution in severe liver disease; dose adjustment may be needed; consult your doctor.
Overdose effects
Overdose is unlikely (hospital use); overdose may lead to hemorrhage; antifibrinolytic therapy, blood transfusions, cryoprecipitate or fresh frozen plasma may be needed.
Storage conditions
Store at 2-8°C; reconstituted solution stable for 24 hours at 2-8°C; contains no preservative, use immediately; keep out of reach of children.
Chemical structure
Streptokinase