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Tissue Plasminogen Activator (t-PA) for Stroke

Examples

Generic Name Brand Name
alteplase Activase

How It Works

Tissue plasminogen activator (t-PA) dissolves blood clots.

Why It Is Used

Tissue plasminogen activator can be used to treat some people who are having a stroke caused by a blood clot (ischemic stroke). It is given in a vein (intravenously, or IV) and in some cases may be given directly into an artery.

The medicine works best if it is given right away after stroke symptoms begin. Strict criteria must be met in order to use the medicine. The medicine can be used to prevent disability after a stroke.

How Well It Works

  • T-PA works best to help people with strokes caused by clots (ischemic strokes) when it is given right away after stroke symptoms begin.1, 2
  • T-PA does not decrease the chance of having another stroke in the future.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Common side effects of this medicine include:

  • Bleeding.
  • Fever.
  • Low blood pressure.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Tissue plasminogen activator should be given right away after the first symptoms of stroke start. The person and/or family members need to provide as much information as possible about what symptoms the person had and when they began. This helps determine whether giving t-PA would be helpful. If it has been too long since the symptoms started, the medicine is unlikely to benefit the person. Other strict criteria also must be met before the medicine can be given.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Hacke W, et al. (2008). Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. New England Journal of Medicine, 359(13): 1317–1329.
  2. Del Zoppo GJ, et al. (2009). Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator: A science advisory from the American Heart Association/American Stroke Association. Stroke, 40(8): 2945–2948.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
Last Revised January 7, 2011

Last Revised: January 7, 2011

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation

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