U-FRAG ( POWDER, INJECTION ) ( 1000000 IU )

• Acute myocardial infarction; pulmonary embolism
• Deep vein thrombosis
• Peripheral vascular thrombosis
• Peripheral arterial thromboembolism
• Arterial thrombosis

Source : IAP Pediatric Drug Formulary
Thromboembolic disease - Loading dose of 4400IU/kg in 15ml soultion over 10min followed by IV infusion 4400IU/kg/hr over 6-12 hr. Blockded arteriovenous shunts, IV cannulas/central lines - 5000IU/kg directly into the catheter and clamp off and retain for 2-4hr. If not cleared, instill 10,000IU and clamp. Monitor with Fibrinogen, TCT, PT, aPTT estimations.

Source : NFI National Formulary of India
Intravenous infusion Deep vein thrombosis: 4,400 units/kg bodyweight in 15 ml Sodium Chloride (0.9%w/v)over 10 min followed by 4,400 units/kgbody weight for 12 to 24 h.Pulmonary embolism: 4,400 units/kg bodyweight in 15 ml Sodium Chloride (0.9%w/v)over 10 min followed by 4,400 units/kgbody weight for 12 to 24 h, alternatively15,000 units/kg body weight directly intothe pulmonary artery initially, subsequentdoses adjusted according to response, max.3 doses in 24 h.

• In recent haemorrhage
• Trauma or surgery (including dental extraction);
• Coagulation defects
• Bleeding diatheses
• Aortic dissection
• Coma
• History of cerebrovascular disease especially recent events or with any residual disability
• Recent symptoms of possible peptic ulceration
• Heavy vaginal bleeding
• Severe hypertension
• Active pulmonary disease with cavitation
• Acute pancreatitis
• Pericarditis
• Bacterial endocarditis
• Severe liver disease and oesophageal varices

• Should be used with caution if there is a risk of bleeding including that from venepuncture or invasive procedures. They should also be used with caution in external chest compression.
• Pregnancy
• Elderly
• Hypertension
• Abdominal aneurysm or other conditions in which thrombolysis might give rise to embolic complications such as enlarged left atrium with atrial fibrillation (risk of dissolution of clot and subsequent embolisation)
• Diabetic retinopathy (very small risk of retinal bleeding) and recent or concurrent use of drugs that increase the risk of bleeding
• Hematocrit platelet count
• Thrombin and prothrombin time

• Nausea, vomiting and bleeding. 
• When used in myocardial infarction, reperfusion arrhythmias may occur. Hypotension can also occur and can usually be controlled by elevating the patient's legs or by reducing the rate of infusion or stopping it temporarily.
• Back pain.
• Fever and convulsions have been reported.
• Bleeding is usually limited to the site of injection; but intracerebral haemorrhage or bleeding from other sites can occur. Serious bleeding calls for discontinuation of the thrombolytic and may require administration of coagulation factors and antifibrinolytic drugs (aprotinin or tranexamic acid). Rarely, further embolism may occur (either due to clots that break away from the original thrombus or to cholesterol crystal emboli). It causes allergic reactions (including rash; flushing and uveitis) and anaphylaxis has also been reported.

Store in a sealed container protected from light in refrigerator (2 to 8⁰C). The container should be sterile, tamper evident and sealed so as to exclude micro-organisms.