Instruction for use: Streptase

Dosage form: Powder lyophilized for the preparation of solution for injection

Active substance: Streptokinasum

ATX

B01AD01 Streptokinase

Pharmacological group

Fibrinolytics

The nosological classification (ICD-10)

H30-H36 Diseases of the choroid and retina: Retinal diseases

H34 Vascular occlusion of retina: Arterial thrombosis of the vessels of the eye; Venous thrombosis of the vessels of the eye; Violation of retinal circulation; Disturbances of intraocular circulation; Insufficient blood supply to the mesh and choroid; Occlusion of central retinal vessels; Acute obstruction of retinal arteries; Subacute and chronic circulatory insufficiency in the retina or in the choroid of the eye; Vascular diseases of the retina; Vascular disorders in the retina of the eye; Vascular thrombosis of the retina; Central retinal vein thrombosis; Thrombosis of the central vein of the retina and its branches; Thrombosis of the central vein of the retina of the eye and its branches

I21 Acute myocardial infarction: Myocardial infarction in the acute phase; Acute Myocardial Infarction; Myocardial infarction with pathologic Q wave and without; Myocardial infarction complicated by cardiogenic shock; Infarction left ventricular; Transmural myocardial infarction; Myocardial infarction netransmuralny (subendocardial); Netransmuralny myocardial infarction; Subendocardial myocardial infarction; The acute phase of myocardial infarction; Acute myocardial infarction;Sub-acute phase of myocardial infarction; Subacute phase of myocardial infarction; Thrombosis of the coronary arteries (the arteries); Threatened myocardial infarction; Myocardial infarction without Q wave

I74 Embolism and arterial thrombosis: Thrombosis of effort (stress); Arterial thrombosis; Arteriothrombosis; Subacute and chronic arterial thrombosis; Subacute thrombosis of peripheral arteries; Postoperative thrombosis; Vascular thrombosis; Vascular embolism; Thrombosis of aortocoronary shunt; Arterial thrombosis; Thrombosis of arteries; Coronary artery thrombosis; Coronary thrombosis; Thrombosis of blood vessels; Thrombosis with ischemic stroke; Thrombosis with general surgical operations; Thrombosis in Oncology Operations; Vascular thrombosis; Thrombus formation in the postoperative period; Thrombotic complications; Thromboembolic diseases; Thromboembolic syndrome; Thromboembolic complication in the postoperative period; Thromboembolism of arteries; Partial vascular thrombosis; Embolism; Embolism of arteries

I77.1 arteriostenosis: Occlusive arterial disease; Peripheral arterial occlusive disease;Peripheral arterial occlusive disease in stages III-IV on Fontaine

I82 Embolism and thrombosis of other veins: Recurrent venous thrombosis; Postoperative thrombosis; Venous thrombosis; Acute venous thromboembolism; Recurrent vein thrombosis; Venous thrombosis; Thrombosis of veins of internal organs; Venous thrombosis; Deep vein thrombosis; Thrombosis of blood vessels; Vascular thrombosis; Thrombosis of veins; Deep vein thrombosis; Thromboembolic diseases; Thromboembolism of veins; Severe venous thrombosis; Embolism; Embolism of veins; Thromboembolic complications

R07.2 Pain in the heart: neuroses of the heart; Myocardial ischemic pain; Pain syndrome in myocardial infarction; cardialgia; cardioneurosis; Cardiac syndrome; Pain in cardiac patients; Cardialgia on background dyshormonal myocardial dystrophy; Functional cardialgia; Psevdostenokardiya; pericardial pain

Composition and release form

1 bottle with lyophilized powder for the preparation of the injection solution contains streptokinase 250,000, 750000 or 1500000 IU; In a box of 1 or 10 bottles.

Characteristic

Highly purified streptokinase from the filtrate of culture fluid of beta-hemolytic streptococcus group Lansfield C.

Pharmachologic effect

Mode of action - Fibrinolytic.

Promotes the transformation of plasminogen into plasmin, causes degradation of fibrinogen and other plasma proteins.

Pharmacokinetics

T1 / 2 - 23 min. Metabolized by hydrolysis. Renal failure does not affect Cl Streptase, hepatic - it slows down.

Clinical Pharmacology

After the infusion is over, the fibrinolytic effect of the drug is observed for several hours, the elongation of thrombin time can persist up to 24 hours due to a simultaneous decrease in the level of fibrinogen and an increase in the number of circulating degradation products of fibrin and fibrinogen.

Indication of the drug Streptase

Acute myocardial infarction, deep vein thrombosis, pulmonary embolism, acute and subacute thrombosis of peripheral arteries, chronic occlusive diseases of the arteries, occlusive injuries of the central vessels of the eye.

Contraindications

Hypersensitivity, internal bleeding, hemorrhagic diathesis, thrombocytopenia, hepatic-renal failure, erosive-ulcerative lesions of the gastrointestinal tract, menstruation, early periods after cerebral circulation, operations, childbirth; Active tuberculosis, intracranial neoplasms, arterial hypertension, hypocoagulation, bleeding, diabetic retinopathy, atrial fibrillation against mitral defect, bacterial endocarditis, pregnancy (first 18 weeks).

Side effects

Fever, chills, headache, gastrointestinal disturbances, generalized exanthema, arthralgia, myalgia, arterial hypotension, tachycardia, bradycardia, bleeding, allergic reactions (including anaphylactic shock).

Interaction

With a combined appointment with anticoagulants, antiplatelet agents, the risk of bleeding increases.

Dosing and Administration

IV the drip, with acute myocardial infarction - 1.5 million IU for one hour. Intracoronary: bolus 20000 IU, followed by infusion over 30-90 min at a rate of 2000-4000 IU / min.

Long-term thrombolysis: initial dose - 250,000 IU / 30 min, supporting - 100,000 IU / h; If thrombin time after 16 hours still exceeds four times the normal value, then a doubled maintenance dose should be administered for several hours until the thrombin time decreases; The duration of treatment depends on clinical efficacy, but it should not exceed 12 hours for central artery thrombosis of the eye and 5 days for any other indication.

Short-term thrombolysis with thrombosis of peripheral arteries or veins: the initial dose is 250,000 IU / 30 min, then for 6 hours the maintenance dose is 1.5 million IU / h.

Local thrombolysis: in / a, 1000-2000 IU, the course dose should not exceed 120,000 IU. After each session of local thrombolysis, additional long-term treatment with heparin should be performed (to avoid retromation).

Storage conditions of the drug Streptase

At a temperature of 2-25 ° C.

Keep out of the reach of children.

The shelf life of the drug Streptase

3 years.

Do not use beyond the expiration date printed on the package.