Streptokinase (Intracoronary, Intravenous)

Streptokinase is a drug that is used to disperse blood clots that have formed in the blood vessels in conditions including pulmonary embolism

Overview

Streptokinase is a drug that is used to dissolve and disperse blood clots that have formed in the blood vessels, resulting in conditions such as pulmonary embolism, and deep vein thrombosis. The drug is also used to remove blood clots that have formed in catheters, which have been inserted into blood vessels.

In the US, the drug is sold under the brand name, Streptase. The medication is only available on prescription from your doctor and is usually administered by a medical professional in a hospital or clinic setting. The drug is supplied in powder form for making into a solution for dosing intravenously or via an intracoronary route.

Conditions treated

  • pulmonary embolism
  • deep vein thrombosis
  • blood clots

Type of medicine

  • powder for solution
  • intravenous
  • intracoronary

Side-effects

Although streptokinase is very effective in dissolving blood clots, it can cause some unwanted side-effects while you are taking it. Before you are treated with streptokinase, you should tell your doctor about any allergic reactions that you have experienced while taking any other form of medication. You must also mention any bad reactions that you have had, as a result of taking other drugs, including non-prescription products, herbal preparations, and vitamin supplements.

Some drugs may contain animal products, preservatives or dyes. Remember to tell your doctor if you have any known allergies to any of these.

The side-effects that are outlined below have occurred in people taking streptokinase. However, this list is not all-inclusive or exhaustive. If you suffer any other nasty side-effects or if you begin to feel at all unwell while taking this medication, you must tell your doctor immediately.

Some people complain of blurred vision when they have received streptokinase. Others report feelings of confusion, feeling lightheaded, dizzy, or faint, especially when rising from a seated or prone position. Other commonly experienced effects of this medication include a fever, sweating, and feeling unusually tired or weak.

Less commonly experienced side-effects of streptokinase include the following:

  • wheezing
  • vomiting blood
  • unusual bruising
  • reddening of the face, arms, neck, and sometimes of the upper chest
  • red or purple spots on the skin
  • nosebleeds
  • muscle or bone pain
  • hives or welts
  • headaches
  • greatly decreased frequency of urination or amount of urine
  • feeling of warmth
  • fast, weak pulse
  • fast heartbeat
  • difficulty with swallowing
  • difficulty with breathing
  • cough, coughing up blood
  • constipation
  • cold clammy skin
  • cloudy urine
  • burning, itching, redness, or soreness of skin
  • blood in urine
  • blood in stools
  • black, tarry stools
  • back pain or backaches
  • abdominal pain or swelling

If you experience any of the above side-effects when you first begin taking streptokinase, you may find that they disappear naturally within a few days, as your body gets used to the new drug. In the meantime, ask your doctor for some ideas to help reduce or prevent some of the more bothersome effects.

It should be noted that not all patients suffer side-effects when taking this medication, but you should always consult your doctor if you have any concerns about any odd effects that you do notice.

Dosage

You will only be given streptokinase intravenously or via the intracoronary route by a trained medical professional in a clinic or hospital. The medication is administered via a cannula or tube that will be placed into one of your blood vessels. The location of the cannula will depend on the nature of your condition, as will the dose administered.

Because streptokinase works to thin the blood, it is sometimes known to cause bleeding in some patients, but this is not usually a serious complication, unless the bleeding becomes severe. This complication can be prevented if you follow your treating physician's instructions. Do not move around excessively, and try not to get out of bed without supervision, unless you are given the all-clear to do so by your doctor or nurse.

Be vigilant for signs of bleeding or oozing of the skin, especially around the injection site or where blood has been drawn from your arm. Check for any signs of blood in your urine or stools. If you notice any form of bleeding anywhere on or from your body, tell your nurse or doctor immediately.

If the person receiving treatment with streptokinase suddenly develops serious side-effects, especially losing consciousness, swelling around the mouth or throat, or develops severe breathing difficulties, you should call 911. These symptoms could mean that the patient has anaphylaxis, a potentially life-threatening condition.

Major drug interactions

Although there are some medicines that should never be used together, in some cases it is appropriate to use two or more different products, even though an interaction is likely to occur. However, your doctor may opt to change the dose of your medications or they might suggest other precautions that you could take to mitigate the effect of any interactions.

Tell your doctor immediately if you are already taking any other medication, including herbal preparations, vitamin supplements or over-the-counter medicines. Some foodstuffs should be avoided, as should consuming alcohol and tobacco, as interactions may sometimes occur, and your doctor will advise you accordingly on this.

It is not generally recommended that streptokinase is used with any of the following medications. Your doctor may decide to change one or more of your current treatment products or may suspend your use of them temporarily.

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

Although taking Aspirin with this medication can increase the risk of certain side-effects, it may be necessary if using both drugs is the best treatment regimen for you. Your doctor may prescribe both drugs, but could opt to change the frequency of use or the dose of one or both of them.

Warnings

If you suffer from certain medical problems, using streptokinase could affect your health. Be sure to tell your treating physician if you suffer from or have a history of any of the following health conditions:

  • bleeding problems or historical bleeding from any part of the body
  • uncontrolled blood clotting disorders
  • diseases of the brain, including tumor
  • uncontrolled hypertension (high blood pressure)
  • stroke within the preceding two months
  • injury or surgery to the brain or spine within two months

Streptokinase should NOT be used if you have ever been affected by any of these conditions.

The use of streptokinase with any of the following can increase the chance of serious bleeding:

  • catheter infection
  • uncontrolled diabetes mellitus
  • eye problems resulting from diabetes or high blood pressure, including hemorrhagic retinopathy
  • heart disease or infections, including endocarditis, or mitral stenosis
  • injections into a blood vessel
  • severe kidney disease
  • severe liver disease
  • tuberculosis, severe bronchitis or other serious lung diseases
  • insertion of a tube into the body
  • recent major injury or surgery of any kind

If you suffer from heart rhythm problems or hypotension, you should not receive treatment with streptokinase, as this drug could make your condition worse.

Streptokinase may not be effective if you have suffered from streptococcal infections such as sore throat or rheumatic fever within the preceding six months.

There is no evidence that streptokinase can cause harm to an unborn baby, but you should still tell your doctor if you are pregnant or if you are planning to become pregnant during your course of treatment with this drug.

It is not known whether streptokinase can pass into breast milk. However, you should mention to your doctor if you are breastfeeding, as it may be advisable to find an alternative method of feeding your infant until your treatment with streptokinase has finished.

Storage

This medication should be kept in a sealed, airtight container. It should not be refrigerated or placed in a freezer.

Do not leave this medication where it will be exposed to direct sunlight, heat or moisture.

Keep the medication well away from children and pets. In the event that a pet consumes streptokinase, seek veterinary advice immediately.

Do not use streptokinase that has passed its use-by date or if the packaging appears to be damaged or opened. This medication should be used immediately once the solution has been made-up. Do not store unused solution for future use.

Ask your doctor or pharmacist for advice on how to dispose of any out-of-date medication. Do not flush leftover drugs down the toilet, pour down the drain, or throw them out with your garbage where they could be eaten by children or animals.

Summary

Streptokinase is a drug that is used in a hospital or clinic setting to dissolve and disperse blood clots that have formed in the blood vessels, resulting in conditions such as pulmonary embolism, and deep vein thrombosis. The drug is also used to dissolve blood clots that have formed in catheters or stents, which have been inserted into blood vessels.

Blood clots are potentially extremely dangerous. If a clot breaks free from the place where it has formed and enters the circulatory system, it could cause catastrophic damage to the brain, lungs, or heart, potentially proving fatal if not diagnosed and treated promptly.

Streptokinase is highly effective in the dispersal and dissolution of blood clots, however it is important that you communicate fully with your doctor during the course of your treatment. This medication cannot cure the underlying cause of the clots, but it can be very helpful in managing the condition and can prove to be life-saving in many cases.

However, there are a number of serious health conditions where streptokinase cannot be used, as well as a large number of prescription and over-the-counter medications that could cause serious interactions if used together with this drug. To achieve the best results, it is important that you work closely with your doctor and make sure that your medical team is fully appraised of your medical history and of any other drugs that you are taking.

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Last Reviewed:
December 24, 2017
Last Updated:
April 05, 2018
Content Source: