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Alteplase - Clearing Catheter Occlusions

Intracatheter:   Cathflo® Activase® (Alteplase) is for instillation into the dysfunctional catheter at a concentration of 1 mg/mL.
DOSAGE AND ADMINISTRATION
• Patients weighing >/=30 kg: 2 mg in 2 mL.
• Patients weighing <30 kg: 110% of the internal lumen volume of the catheter, not to exceed 2 mg in 2 mL.

If catheter function is not restored at 120 minutes after 1 dose of Cathflo Activase, a second dose may be instilled (see INSTRUCTIONS FOR ADMINISTRATION). There is no efficacy or safety information on dosing in excess of 2 mg per dose for this indication. Studies have not been performed with administration of total doses greater than 4 mg (two 2‑mg doses).  Package insert.


Instructions for Administration
Preparation of Solution:
Reconstitute Cathflo Activase to a final concentration of 1 mg/mL:

Aseptically withdraw 2.2 mL of Sterile Water for Injection, USP (diluent is not provided). Do not use Bacteriostatic Water for Injection.
Inject the 2.2 mL of Sterile Water for Injection, USP, into the Cathflo Activase vial, directing the diluent stream into the powder. Slight foaming is not unusual; let the vial stand undisturbed to allow large bubbles to dissipate.
Mix by gently swirling until the contents are completely dissolved. Complete dissolution should occur within 3 minutes. DO NOT SHAKE. The reconstituted preparation results in a colorless to pale yellow transparent solution containing 1 mg/mL Cathflo Activase at a pH of approximately 7.3.
Cathflo Activase contains no antibacterial preservatives and should be reconstituted immediately before use. The solution may be used for intracatheter instillation within 8 hours following reconstitution when stored at 2-30°C (36-86°F).
No other medication should be added to solutions containing Cathflo Activase.

Instillation of Solution into the Catheter
Inspect the product prior to administration for foreign matter and discoloration.
Withdraw 2 mL (2 mg) of solution from the reconstituted vial.
Instill the appropriate dose of Cathflo Activase (see DOSAGE AND ADMINISTRATION) into the occluded catheter.
After 30 minutes of dwell time, assess catheter function by attempting to aspirate blood. If the catheter is functional, go to Step 7. If the catheter is not functional, go to Step 5.
After 120 minutes of dwell time, assess catheter function by attempting to aspirate blood and catheter contents. If the catheter is functional, go to Step 7. If the catheter is not functional, go to Step 6.
If catheter function is not restored after one dose of Cathflo Activase, a second dose of equal amount may be instilled. Repeat the procedure beginning with Step 1 under Preparation of Solution.
If catheter function has been restored, aspirate 4-5 mL of blood in patients >/=10 kg or 3 mL in patients <10 kg to remove Cathflo Activase and residual clot, and gently irrigate the catheter with 0.9% Sodium Chloride Injection, USP.   Any unused solution should be discarded.

Stability and Storage
Store lyophilized Cathflo Activase at refrigerated temperature (2-8°C/36-46°F). Do not use beyond the expiration date on the vial. Protect the lyophilized material during extended storage from excessive exposure to light.

HOW SUPPLIED
Cathflo Activase (Alteplase) for injection is supplied as a sterile, lyophilized powder in 2 mg vials.

Each Cathflo®Activase® carton contains one 2 mg vial of Cathflo® Activase® (Alteplase): NDC 50242‑041‑64.

Disclaimer

Listed dosages are for - Adult patients ONLY. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. GlobalRPH does not directly or indirectly practice medicine or provide medical services and therefore assumes no liability whatsoever of any kind for the information and data accessed through the Service or for any diagnosis or treatment made in reliance thereon.

David F. McAuley, Pharm.D., R.Ph.  GlobalRPh Inc.
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