Acute MI 90 min (accelerated) dose regimen: Start w/in 6 hr after symptom onset.
Patient ≥65 kg 15 mg IV bolus, immediately followed by 50 mg IV infusion over the 1st 30 min, immediately followed by 35 mg IV infusion over 60 min until max total dose of 100 mg,
<65 kg Total dose should be wt adjusted w/ 15 mg IV bolus, immediately followed by 0.75 mg/kg IV infusion over the 1st 30 min (max: 50 mg), immediately followed by 0.5 mg/kg IV infusion over 60 min (max: 35 mg). 3 hr dose regimen: Start between 6 & 12 hr after symptom onset.
Patient ≥65 kg 10 mg IV bolus, immediately followed by 50 mg IV infusion over the 1st hr, immediately followed by 40 mg IV infusion over 2 hr until max total dose of 100 mg,
<65 kg 10 mg IV bolus, immediately followed by IV infusion over 3 hr up to max total dose of 1.5 mg/kg.
Patient w/ ST-elevation MI Antithrombotic adjunctive therapy is recommended.
Acute massive pulmonary embolism Patient ≥65 kg Administer total dose of 100 mg in 2 hr. Most experience available is w/ the following dose regimen: 10 mg IV bolus over 1-2 min, immediately followed by 90 mg IV infusion over 2 hr until total dose of 100 mg,
<65 kg 10 mg IV bolus over 1-2 min, immediately followed by IV infusion up to max total dose of 1.5 mg/kg. Adjunctive therapy: Initiate/resume heparin therapy after Actilyse when aPTT values are <2 times the ULN. Adjust infusion to maintain aPTT between 50-70 sec.
Acute ischaemic stroke Recommended total dose: Infuse 0.9 mg/kg (max: 90 mg) starting w/ 10% of total dose administered as an initial IV bolus, immediately followed by remainder of total dose infused IV over 60 min. Initiate treatment as early as possible w/in 4.5 hr of symptom onset. Adjunctive therapy: Avoid heparin IV or platelet aggregation inhibitors (eg, ASA) in the 1st 24 hr after Actilyse. If heparin is required for other indications (eg, DVT prevention) the dose should not exceed 10,000 IU daily SC.