PULMONARY EMBOLISM (PE), DEEP VEIN THROMBOSIS (DVT):
Initially 4400 IU/kg over 10 min followed by 4400 IU/kg/hr. Alternatively in PE, 15000 IU/kg may be given as bolus injection into pulmonary artery repeated every 24 hrs for 3 doses.
Intra coronary ACUTE MI : 6000 IU/min for up to 2 hrs should be preceded by IV heparin or IV doses of UK at 2-3 mio units over 45 to 90 min.
PERIPHERAL VASCULAR OCCLUSION: 4000 UNITS/MIN via a catheter into the clot as a solution containing 2500 unit/ml. Catheter is advanced into the occlusion every 2 hrs until free flow is resumed.
CLEARANCE OF OCCLUDED CATHETERS AND SHUNTS: Up to 25000 units in 2-3 ml of 0.9% Nacl instilled and clamped off for 2-4 hrs
A thrombolytic agent obtained from human kidney cells by tissue culture. Urokinase directly convert plasminogen into plasmin which then degrades fibrin clots as well as fibrinogen and other plasma proteins.
Aspirin, Cefamandole, Divalproex, Enoxaparin, Heparin, Indomethacin, anti-inflammatory drugs or analgesics (except narcotics), Phenylbutazone, Plicamycin, Sulfinpyrazone, Ticlopidine or Valproic acid: when used together with Urokinase increases the chances of bleeding .
Effect & Precaution
Drug fever, haemorrhage
Allergies: Allergic reaction to Urokinase may occur. Pregnancy :There is a slight chance that use of a thrombolytic agent during the first five months of pregnancy may cause a miscarriage. Older adults: The need for treatment with a thrombolytic agent may be increased in elderly patients with blood clots, however, the chance of bleeding may also be increased.
Pregnancy: Safety not established.
Breast Feeding: Safety not establishe.
Man: Use with caution.