Cathflo Activase

Medical Editor: John P. Cunha, DO, FACOEP Last updated on RxList: 10/26/2021
Cathflo Activase Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

What Is Cathflo Activase?

Cathflo Activase (alteplase) is a tissue plasminogen activator (t-PA) indicated for the restoration of function to central venous access devices as assessed by the ability to withdraw blood.

What Are Side Effects of Cathflo Activase?

Common side effects of Cathflo Activase include:

  • bleeding (may be serious),
  • blood clots, and
  • infection

Dosage for Cathflo Activase

Cathflo Activase is for instillation into the dysfunctional catheter at a concentration of 1 mg/mL. The dose of Cathflo Activase for patients weighing 30kg or more is 2 mg in 2mL. The dose of Cathflo Activase for patients weighing less than 30 kg is 110% of the internal lumen volume of the catheter, not to exceed 2mg in 2 mL.

What Drugs, Substances, or Supplements Interact with Cathflo Activase?

Cathflo Activase may interact with other drugs. Tell your doctor all medications and supplements you use.

Cathflo Activase During Pregnancy or Breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant before using Cathflo Activase; it is unknown how it may affect a fetus. It is unknown if Cathflo Activase passes into breast milk. Consult your doctor before breastfeeding.

Additional Information

Our Cathflo Activase (alteplase) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Cathflo Activase Consumer Information

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Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Alteplase increases your risk of bleeding, which can be severe or fatal. Call your doctor or seek emergency medical attention if you have bleeding that will not stop. Bleeding may occur from a surgical incision, or from the skin where a needle was inserted during a blood test or while receiving injectable medication. You may also have bleeding on the inside of your body, such as in your stomach or intestines, kidneys or bladder, brain, or within the muscles.

Call your doctor or get emergency medical help if you have signs of bleeding, such as:

  • sudden headache, feeling very weak or dizzy;
  • bleeding gums, nosebleeds;
  • easy bruising;
  • bleeding from a wound, incision, catheter, or needle injection;
  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
  • red or pink urine;
  • heavy menstrual periods or abnormal vaginal bleeding; or
  • sudden numbness or weakness (especially on one side of the body), slurred speech, problems with vision or balance.

Also call your doctor at once if you have:

  • chest pain or heavy feeling, pain spreading to the jaw or shoulder, nausea, sweating, general ill feeling;
  • swelling, rapid weight gain, little or no urination;
  • severe stomach pain, nausea, and vomiting;
  • darkening or purple discoloration of your fingers or toes;
  • very slow heartbeats, shortness of breath, feeling light-headed;
  • sudden severe back pain, muscle weakness, numbness or loss of feeling in your arms or legs;
  • increased blood pressure--severe headache, blurred vision, pounding in your neck or ears, anxiety, nosebleed; or
  • pancreatitis--severe pain in your upper stomach spreading to your back, nausea and vomiting.

Bleeding is the most common side effect of alteplase.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Cathflo Activase (Alteplase Powder for Reconstitution for Use in Central Venous Access Devices)

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Cathflo Activase Professional Information

SIDE EFFECTS

In the clinical trials, the most serious adverse events reported after treatment were sepsis (see PRECAUTIONS, Infections), gastrointestinal bleeding, and venous thrombosis.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Trials 1 And 2

The data described for Trials 1 and 2 reflect exposure to Cathflo Activase in 1122 patients, of whom 880 received a single dose and 242 received two sequential doses of Cathflo Activase.

In the Cathflo Activase Trials 1 and 2, only limited, focused types of serious adverse events were recorded, including death, major hemorrhage, intracranial hemorrhage, pulmonary or arterial emboli, and other serious adverse events not thought to be attributed to underlying disease or concurrent illness. Major hemorrhage was defined as severe blood loss ( > 5 mL/kg), blood loss requiring transfusion, or blood loss causing hypotension. Nonserious adverse events and serious events thought to be due to underlying disease or concurrent illness were not recorded. Patients were observed for serious adverse events until catheter function was deemed to be restored or for a maximum of 4 or 6 hours depending on study. For most patients the observation period was 30 minutes to 2 hours. Spontaneously reported deaths and serious adverse events that were not thought to be related to the patient's underlying disease were also recorded during the 30 days following treatment.

Four catheter-related sepsis events occurred from 15 minutes to 1 day after treatment with Alteplase, and a fifth sepsis event occurred on Day 3 after Alteplase treatment. All 5 patients had positive catheter or peripheral blood cultures within 24 hours after symptom onset.

Three patients had a major hemorrhage from a gastrointestinal source from 2 to 3 days after Alteplase treatment. One case of injection site hemorrhage was observed at 4 hours after treatment in a patient with pre-existing thrombocytopenia. These events may have been related to underlying disease and treatments for malignancy, but a contribution to occurrence of the events from Alteplase cannot be ruled out. There were no reports of intracranial hemorrhage.

Three cases of subclavian and upper extremity deep venous thrombosis were reported 3 to 7 days after treatment. These events may have been related to underlying disease or to the long-term presence of an indwelling catheter, but a contribution to occurrence of the events from Alteplase treatment cannot be ruled out. There were no reports of pulmonary emboli.

There were no gender-related differences observed in the rates of adverse reactions. Adverse reactions profiles were similar across all age subgroups.

Trial 3

In Trial 3 all serious adverse events were recorded with a specific interest in intracranial hemorrhage, major hemorrhage, thrombosis, embolic events, sepsis and catheter related complications. Major hemorrhage was defined as severe blood loss ( > 5 mL/kg), blood loss requiring transfusion, or blood loss causing hypotension. Non-serious adverse events were not recorded. Patients were observed until catheter function was deemed to be restored or for a maximum of 4 hours after the first dose. Additionally, serious adverse events were elicited from patients at 48 hours (up to 96 hours) following completion of treatment.

No pediatric patients in Trial 3 experienced an intracranial hemorrhage, major hemorrhage, thrombosis, or an embolic event.

Three cases of sepsis occurred 2 to 44 hours after treatment with Cathflo Activase. All of these patients had evidence of infection prior to administration of Cathflo Activase. An additional patient developed fever and lethargy within one day of Cathflo Activase administration, which required outpatient intravenous antibiotics. In one subject, the lumen of the catheter, placed 2 years previously, ruptured with infusion of the study drug.

There were no gender-related differences observed in the rates of adverse reactions. Adverse reactions profiles were similar across all age groups.

Allergic Reactions

No allergic-type reactions were observed in the trials in patients treated with Alteplase. If an anaphylactic reaction occurs, appropriate therapy should be administered.

Read the entire FDA prescribing information for Cathflo Activase (Alteplase Powder for Reconstitution for Use in Central Venous Access Devices)

© Cathflo Activase Patient Information is supplied by Cerner Multum, Inc. and Cathflo Activase Consumer information is supplied by First Databank, Inc., used under license and subject to their respective copyrights.

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