Streptokinase (Intravenous, Intracoronary)

Streptokinase is used to break down blood clots that have formed in the blood vessels. It is given right after heart attack symptoms start to help improve 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. However, some people may experience serious bleeding. To help prevent serious bleeding, closely follow any instructions from your doctor. Move 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, look 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 must consider the risks against the benefits. For this medicine, consider the following:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also inform your health care professional about any other allergies you have, like 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. Safety and effectiveness have not been established.

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. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while in other cases, two different medicines may be used together even if an interaction might occur. If you are receiving this medicine, it is especially important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions are selected based on 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 take.

• 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 drugs may be necessary for your treatment. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both medicines.

• Aspirin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used around the time of eating certain foods, as interactions may occur. Using alcohol or tobacco with certain medicines may also lead to interactions. The following interactions are selected based on their potential significance and are not necessarily all-inclusive.

Other Medical Problems

Having other medical problems may affect the use of this medicine. Make sure to inform your doctor if you have any other medical conditions, especially:

• Bleeding problems or a history of bleeding anywhere in 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 problems 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 risk of serious bleeding may be increased.

• Heart rhythm problems, or
• Hypotension—These conditions may worsen.

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

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may require medical attention.

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

More common

• Blurred vision
• Confusion
• Dizziness, faintness, or lightheadedness when standing up suddenly from a lying or sitting position
• Fever
• Sweating
• Unusual tiredness or weakness

Less common

• Blood in stool
• Blood in urine
• Nosebleeds
• 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 breathing
• Difficulty swallowing
• Dizziness
• Fast heartbeat
• Fast, weak pulse
• Feeling of warmth
• Significantly 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 sometimes, upper chest
• Shortness of breath
• Skin rash
• Tightness in chest
• Wheezing

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

Call your doctor for medical advice about side effects. You can 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.