Reteplase, Recombinant (Intravenous)

Reteplase, Recombinant is also known under brand name Retavase in the US. It's a drug that is used in the treatment of heart attacks. It is used immediately after a heart attack occurs.


Reteplase is a drug that is used in the treatment of heart attacks. It works by dissolving any clots that have formed in the hearts blood vessels. This medication is used immediately after a heart attack occurs and is only available via prescription from your doctor. A trained health professional or doctor will give you reteplase, recombinant. It's given via a needle placed into one of your veins. This product is available in the dosage form of powder for solution and kit.

Conditions Treated

  • Heart attack

Type of Medicine

  • Powder for solution

Side Effects

Along with its intended effects, the use of reteplase, recombinant can produce some unwanted side effects. Not all of these side effects may occur, however, if any of them do, you may require medical attention.

Inform your doctor or a healthcare professional urgently if you suffer from any of the following side effects whilst taking this drug.

More common side effects:

  • Bleeding from the bladder, blood in urine
  • Bleeding at injection site
  • Black or bloody, tarry stools
  • Vomiting of blood or material that looks like coffee grounds
  • Severe stomach pain

Less common side effects:

  • Pale skin
  • Unusual bruising or bleeding
  • Troubled breathing with exertion
  • Unusual weakness or tiredness

Rare side effects:

  • Blurred vision
  • Difficult or labored breathing
  • Confusion
  • Cough
  • Difficulty swallowing
  • Fast heartbeat
  • Faintness, dizziness or lightheadedness when getting up from a sitting or lying position suddenly
  • Hives
  • Swelling or puffiness of the eyelids or around the face, eyes, lips, or tongue
  • Itching
  • Shortness of breath
  • Sweating
  • Skin rash
  • Wheezing
  • Tightness in chest

Remember you can report all side effects, regardless of their severity, to the FDA on 1-800-FDA-1088.


The final dosage of any medication will depend on a number of factors. These include your age, weight and height, your past medical history, medications you are currently taking and how you react to the first dose. The following dosage is typical and if you have any questions or queries you should speak with your doctor prior to administration.

Retavase is administered as a ten plus ten unit double-bolus injection. Two ten unit bolus injections are required to complete a treatment. Each bolus is administered as an intravenous injection over a two minute period. The second bolus is given thirty minutes after the first bolus injection has been given. Each bolus injection should be given via a clean intravenous line in which no other drug has been infused or injected. No other medications should be added to the injection solution that contains this drug.


Interactions occur between drugs which can lead to severe side effects and affect the effectiveness of each drug. To avoid these interactions, it's important that you give your doctor or a healthcare professional a full list of the current and past medication you are taking. This list should include prescription and non-prescription drugs, all herbal remedies/products, and vitamins. You should also inform your doctor of your medical history including any medical conditions you currently suffer from and have suffered from in the past. This should include any medical conditions that run in your family history.

The use of this medication with any of the following drugs is not recommended. Your doctor may decide to avoid treating you with this medicine or change some of the other medications you are taking.

  • Defibrotide

The use of this medication with any of the following medicines is not usually recommended, but in some cases, it may be necessary. If you are prescribed both medications, your doctor may alter the dose or frequency of one or both medications.

  • Alteplase, Recombinant
  • Acenocoumarol
  • Anistreplase
  • Argatroban
  • Apixaban
  • Ardeparin
  • Aspirin
  • Bivalirudin
  • Bemiparin
  • Certoparin
  • Dalteparin
  • Dabigatran Etexilate
  • Danaparoid
  • Edoxaban
  • Desirudin
  • Enoxaparin
  • Heparin
  • Fondaparinux
  • Lepirudin
  • Parnaparin
  • Nadroparin
  • Pentosan Polysulfate Sodium
  • Phenprocoumon
  • Phenindione
  • Reviparin
  • Protein C
  • Rivaroxaban
  • Tenecteplase
  • Streptokinase
  • Tinzaparin
  • Warfarin
  • Urokinase

There are over 223 drugs that are known to interact with reteplase. The following list is not complete, which is why it's important you let your doctor know all the drugs you are taking. You should let your doctor know if you are taking any of the following medications.

  • Aminocaproic acid
  • Aprotinin
  • Perindopril / amlodipine
  • Bromfenac
  • Choline salicylate
  • Citalopram
  • Bromfenac ophthalmic
  • Choline salicylate / magnesium salicylate
  • Cilostazol
  • Clomipramine
  • Collagenase clostridium histolyticum
  • Clopidogrel
  • Conestat alfa
  • Captopril / hydrochlorothiazide
  • Capsaicin / diclofenac topical
  • Captopril
  • Deoxycholic acid
  • Diclofenac
  • Desvenlafaxine
  • Dexfenfluramine
  • Diclofenac ophthalmic
  • Diclofenac / fluorouracil topical
  • Diclofenac topical
  • Diclofenac / misoprostol
  • Diphenhydramine / ibuprofen
  • Diflunisal
  • Diltiazem / enalapril
  • Diphenhydramine / magnesium salicylate
  • Dipyridamole
  • Diphenhydramine / naproxen
  • Dong quai
  • Doxycycline / omega-3 polyunsaturated fatty acids
  • Enalapril / hydrochlorothiazide
  • Duloxetine
  • Enalapril / felodipine
  • Epoprostenol
  • Escitalopram
  • Etodolac
  • Esomeprazole / naproxen
  • Famotidine / ibuprofen
  • Fenoprofen
  • Fenfluramine
  • Fluoxetine
  • Flurbiprofen ophthalmic
  • Fluoxetine / olanzapine
  • Flurbiprofen
  • Fluvoxamine
  • Garlic
  • Fosinopril
  • Fosinopril / hydrochlorothiazide
  • Ginger
  • Ginkgo
  • Ginger / magnesium sulfate / pyridoxine
  • Ginseng
  • Hydrochlorothiazide / moexipril
  • Hemin
  • Horse chestnut
  • Hydrocodone / ibuprofen
  • Hydrochlorothiazide / lisinopril
  • Hydrochlorothiazide / quinapril
  • Icosapent
  • Ibuprofen
  • Iloprost
  • Indomethacin
  • Ketamine / ketoprofen / lidocaine topical
  • Ketoprofen / lidocaine topical
  • Ketoprofen
  • Ketorolac
  • Levomilnacipran
  • Ketorolac ophthalmic
  • Lisinopril
  • Magnesium salicylate / phenyltoloxamine
  • Magnesium salicylate
  • Meclofenamate
  • Meloxicam
  • Mefenamic acid
  • Moexipril
  • Nabumetone
  • Milnacipran
  • Naproxen
  • Naproxen / sumatriptan
  • Naproxen / pseudoephedrine
  • Nepafenac ophthalmic
  • Oxaprozin
  • Nintedanib
  • Paroxetine
  • Pentoxifylline
  • Pentosan polysulfate sodium
  • Perindopril
  • Piroxicam
  • Phenylbutazone
  • Quinapril
  • Rofecoxib
  • Ramipril
  • Salsalate
  • Sibutramine
  • Sertraline
  • Sodium salicylate
  • Sulfinpyrazone
  • Sodium thiosalicylate
  • Sulindac
  • Ticagrelor
  • Suprofen ophthalmic
  • Tolmetin
  • Ticlopidine
  • Trandolapril
  • Tranexamic acid
  • Trandolapril / verapamil
  • Valdecoxib
  • Treprostinil
  • Vilazodone
  • Venlafaxine
  • Vortioxetine

Other medical conditions

If you suffer from other medical conditions, this may affect the use of this drug. Ensure you inform your doctor or a healthcare professional of any other medical conditions you may suffer from, especially:

  • Bleeding problems or a history of bleeding in any part of the body
  • High blood pressure, uncontrolled
  • Blood vessel problems (an aneurysm)
  • Brain disease or tumor
  • Stroke, history of
  • Blood clots, history of
  • Surgery or injury to the brain or spine, recent. This medication should NOT be used in those who suffer from conditions.
  • Diabetic eye problems (retinopathy)
  • Injections into a blood vessel
  • Heart infections (endocarditis, pericarditis)
  • Kidney disease, severe
  • Placement of any tube into the body
  • Liver disease, severe
  • High cholesterol, history of. There is an increased risk of serious side effects when using this medication.
  • Surgery or injury of any kind, major and recent. The use of this medication should increase the chance of serious bleeding.
  • Heart rhythm problems - This medication could cause this condition to worsen.


Use in pediatric patients

Studies have not been conducted on the relationship of age to the effects of reteplase on the pediatric population. Therefore efficacy and safety have not been established.

Use in geriatric patients

No information or studies are available on the relationship of age to the effects of reteplase in older patients. However, elderly patients are more at risk of serious bleeding from this medication.

Use in pregnancy and breastfeeding

This drug is under FDA pregnancy category C. The use of this medication should only be used when necessary. You should speak with your doctor about the potential benefits and risks that are associated with taking this drug while pregnant. If you fall pregnant, let your doctor know right away.

With regards to breastfeeding, there are no known studies in women that determine child risk when using this drug during breastfeeding. You should discuss with your doctor the potential benefits and the potential risks before taking this drug whilst breastfeeding an infant.

This drug can cause bleeding that's not usually serious. However, serious bleeding can occur in some people. To help prevent serious bleeding, you should carefully follow any instructions given by a healthcare professional or your doctor. Try not to move around and don't get out of bed on your own. The exception is unless a doctor has told you it's okay to do so.

Keep watch for any oozing or bleeding on your skin, such as around the injection site or where blood was drawn from your arm. Also, check for blood in your bowel movements and urine. If you experience any injuries or bleeding, inform your doctor or a healthcare professional immediately.


All dosage kits need to be stored at 36°F - 77°F (2°C - 25°C) and remain sealed until they are required for treatment. This is to protect them from direct light.


When used correctly, Reteplase, recombinant is successful in the treatment of heart attacks when given after the heart attack has occurred. Due to the high number of drugs and health complications that can interact with the effectiveness of this drug, it's vital you let your doctor know of any medications and conditions you are currently taking/suffer from. This drug should only be used during pregnancy and breastfeeding when it's vital to do so as the risk of bleeding may be increased in pregnant women. You should come to that conclusion after weighing up the benefits and risks associated with taking this drug. This drug will be administered in a hospital under the supervision of a healthcare professional or doctor.

Last Reviewed:
January 30, 2018
Last Updated:
April 26, 2018
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