Streptase (Intravenous, Intracoronary)

Streptokinase is used to dissolve blood clots that form in blood vessels. It is used right after heart attack symptoms start to help improve patient survival. This medicine may also be used to treat blood clots in the lungs (pulmonary embolism) and in the legs (deep venous thrombosis).

Streptokinase is also used to dissolve blood clots in tubes (catheters) that are placed in blood vessels.

This medicine is available only with your doctor's prescription.

Streptokinase can cause bleeding that is usually not serious, but serious bleeding may happen in some people. To help prevent serious bleeding, carefully follow any instructions from your doctor. Move around as little as possible, and do not get out of bed on your own unless your doctor says it is okay.

Watch for any bleeding or oozing on your skin, especially around the injection site or where blood was drawn from your arm. Also, check for blood in your urine or bowel movements. If you notice any bleeding or injuries, inform your doctor or nurse immediately.

In deciding to use a medicine, you and your doctor need to weigh the risks of taking the medicine against the benefits it may provide. For this medicine, consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also, let your healthcare professional know if you have any other allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, carefully read the label or package ingredients.

Pediatric

There have not been appropriate studies on how age affects the use of streptokinase in children. Its safety and effectiveness have not been established for this group.

Geriatric

There is no information available on how age affects the use of streptokinase in older adults.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medication during breastfeeding. Consider the potential benefits and risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be taken together, while in other cases, two different medicines can be used together even if an interaction might happen. In these situations, your doctor may adjust the dose or take other precautions. It is very important that your healthcare professional knows if you are taking any of the medicines listed below when you are receiving this medicine. The following interactions have been chosen for their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you are taking.

• Defibrotide

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

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

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both medicines may be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or frequency of one or both medicines.

• Aspirin

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used around the time of eating or with certain types of food due to potential interactions. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions have been chosen for their potential significance and are not necessarily all-inclusive.

Other Medical Problems

Other medical issues may affect the use of this medicine. Be sure to inform your doctor if you have any other medical conditions, especially:

• Bleeding problems or a history of bleeding in any part of the body or
• Uncontrolled blood clotting disorder or
• Brain disease or tumor or
• Uncontrolled high blood pressure or
• Recent stroke (within two months) or
• Recent surgery or injury to the brain or spine (within two months)—This medicine should NOT be used in these situations.

• Catheter (tube) infection or
• Uncontrolled diabetes mellitus or
• Eye issues from diabetes (e.g., hemorrhagic retinopathy) or high blood pressure or
• Heart disease or infections (e.g., mitral stenosis or endocarditis) or
• Injections into a blood vessel or
• Severe kidney disease or
• Severe liver disease or
• Lung disease (e.g., tuberculosis or severe bronchitis) or
• Pancreatitis or
• Placement of any tube into the body or
• Major and recent surgery or injury—The chance of serious bleeding may be increased.

• Heart rhythm issues or
• Low blood pressure—These conditions may worsen.

• Recent streptococcal infection (within 6 months) (e.g., sore throat, rheumatic fever)—This medicine may not work effectively.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

• Blurred vision
• confusion
• dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
• fever
• sweating
• unusual tiredness or weakness

Less common

• Blood in stool
• blood in urine
• nose bleeds
• red or purple spots on skin
• unusual bruising
• vomiting blood

Rare

• Abdominal pain or swelling
• back pain or backaches
• black, tarry stools
• burning, itching, redness, or soreness of skin
• cloudy urine
• cold clammy skin
• constipation
• cough
• coughing up blood
• difficulty with breathing
• difficulty with swallowing
• dizziness
• fast heartbeat
• fast, weak pulse
• feeling of warmth
• greatly decreased frequency of urination or amount of urine
• headaches
• hives or welts
• large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• lightheadedness
• muscle or bone pain
• nausea and vomiting
• noisy breathing
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• redness of the face, neck, arms, and occasionally, upper chest
• shortness of breath
• skin rash
• tightness in chest
• wheezing

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Streptase

Pharmacologic Class: Tissue Plasminogen Activator

A doctor or other trained health professional will give you this medicine. This medicine is given through a needle or tube placed into one of your blood vessels.