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Streptokinase

    Brands

    DAE Class; Rx

    Common Brand Names; KABIKINASE

    • Anticoagulants/Platelet deaggregators
    Streptokinase is a nonenzymatic protein produced by group C ß-hemolytic streptococci. Clinically, Streptokinase is used as a parenteral thrombolytic agent in the management of acute myocardial infarction, pulmonary embolism, deep vein thrombosis, occluded arteriovenous cannulae, and acute arterial thrombosis and embolism. Unlike urokinase, repeated administration of it can result in tolerance and/or hypersensitivity. Streptokinase is considerably less expensive than other thrombolytics.

    Streptokinase is primarily indicated in conditions like Acute myocardial infarction, Arterial thrombosis, Deep vein thrombosis, Desloughing wounds, Duodenal ulcer and gastric ulcer, Myocardial infarction, Prophylaxis of NSAID-associated gastric or duodenal ulcer, Pulmonary embolism, Thrombosis.

    Streptokinase is contraindicated in conditions like Hypertension, Peptic ulcer, Cardiac stroke, Trauma, Bleeding diathesis.

    Significant: Coronary thrombolysis; hypotension, tachycardia and/or bradycardia during initial infusion. Rarely, anaphylactic reactions.
    Cardiac disorders: Angina pectoris, heart failure, reinfarction, cardiogenic shock, pericarditis.
    Gastrointestinal disorders: Nausea, vomiting, diarrhoea, epigastric pain, gastrointestinal bleeding.
    General disorders and administration site conditions: Injection site bleeding, ecchymoses, chills, fever, asthenia, malaise.
    Immune system disorders: Antistreptokinase antibody development.
    Musculoskeletal and connective tissue disorders: Musculoskeletal pain.
    Nervous system disorders: Headache.
    Renal and urinary disorders: Genitourinary bleeding.
    Respiratory, thoracic and mediastinal disorders: Pulmonary oedema.

    Before starting therapy with streptokinase determine hematocrits, platelets counts, thrombin time, prothrombin time, activated partial thromboplastin time, fibrinogen levels.

    Drug should not be given to Geriatrics, and Neonates.

    Indications and Dosage
    Intra-arterial, Intravenous
    Peripheral arterial occlusive disease
    Adult: Via intra-arterial infusion: Gradual infusion: 1,000-2,500 units every 3-5 minutes for a maximum of 10 hours. Max dose: 250,000 units; Prolonged continuous low-dose infusion: 5,000-10,000 units hourly. Max treatment duration: 5 days. As an alternative for difficult arterial access or due to multiple occlusions; Initial: 250,000 units over 30 minutes via IV infusion. Maintenance infusion: 100,000 units hourly for up to 5 days.

    Intravenous
    Acute myocardial infarction
    Adult: Within 12 hours of onset with persistent ST-segment elevation or recent left bundle-branch block: 1,500,000 units as a single dose via infusion over 60 minutes.

    Intravenous
    Deep vein thrombosis
    Adult: Initially, 250,000 units via infusion over 30 minutes. Maintenance infusion: 100,000 units hourly for 72 hours.

    Intravenous
    Pulmonary embolism
    Adult: Initially, 250,000 units via infusion over 30 minutes. Maintenance infusion: 100,000 units hourly for 24 hours. Alternatively, 1,500,000 units over 1-2 hours.

    Intravenous
    Central retinal artery thrombosis, Central retinal vein thrombosis
    Adult: Initially, 250,000 units via infusion over 30 minutes. Maintenance infusion: 100,000 units hourly for 12 hours.

    Streptokinase

    Injection

    • 1.5 MIU