Urokinase Indications
Urokinase is used in arterial-venous shunts, clots and venous canals, thrombolysis in the eye, deep vein thrombosis, pulmonary embolism, and peripheral vascular occlusion.
Urokinase Pharmacokinetics
This drug is rapidly metabolized in the liver. The half-life of urokinase is up to 20 minutes. The time required to reach the peak effect of restoring cardiac muscle perfusion is 20 minutes to 2 hours (average 45 minutes) after starting intravenous therapy. The effect of the drug disappears a few hours after cessation of use. Within 4 hours after discontinuation of treatment, prothrombin time may rarely persist for 24 hours after cessation of treatment.
Urokinase Contraindications
Urokinase should not be used in the following cases:
Ruptured or suspected aneurysm, active bleeding, brain tumor, cerebrovascular injury or history, intracranial or intrathecal neurosurgery during the two months prior to treatment, recent chest surgery, recent trauma to the central nervous system, severe And uncontrollable hypertension and severe allergic reactions or anaphylaxis to urokinase, coagulation defects, coma, recent gastrointestinal symptoms, severe vaginal bleeding, acute pancreatitis, and severe hepatic impairment.
Side effects of Urokinase
The side effects of this drug are mainly nausea, vomiting and bleeding. Back pain has also been reported with this medication. Bleeding is usually limited to the injection site. However, bleeding may occur inside the brain or from other sites.
Urokinase Drug Interactions
Concomitant use of oral anticoagulants or heparin with urokinase is not recommended due to the increased risk of bleeding in general. Concomitant use of fibrin anticoagulants, such as tranexamic acid and aprotinin with urokinase, eliminates the thrombolytic effect of this drug and the antihypertensive effect of fibrin. Taking nonsteroidal anti-inflammatory drugs (NSAIDs), especially indomethacin and acetylsalicylic acid in combination with urokinase, may increase the risk of heavy bleeding. Concomitant use of uroprolic acid with urokinase may increase the risk of severe bleeding.
Urokinase Warnings
- This medicine should be used with caution in the following cases:
Existence of any primary or secondary blood coagulation defects, delivery within 10 days before starting treatment, subacute bacterial endocarditis, severe gastrointestinal bleeding within 10 days before starting treatment, neurosurgery within 2 months before starting treatment, organ biopsy within 10 days Prior to treatment, perforation of blood vessels within 10 days prior to treatment, any major surgery other than neurosurgery or chest surgery within 10 days prior to treatment, and recent severe trauma, mitral valve stenosis with atrial fibrillation, or other symptoms Possible thrombosis in the left half of the heart, retinal damage caused by streptokinase treatment for 5 days to 6 months before resumption of treatment. - In case of severe bleeding, the drug should be discontinued and, if necessary, coagulation factors and anti-fibrin dissolving drugs (aprotinin or tranexamic acid) should be
prescribed. - Treatment with thrombolytic drugs for use other than acute coronary artery thrombosis should only be performed in hospitals with trained equipment and personnel recommended for diagnostic procedures and tests.
- During treatment with this drug, the patient should be fully hospitalized and monitored.
Urokinase drug recommendations
1- Completing the course of treatment with complete rest and following all the doctor’s instructions is necessary in order to minimize bleeding.
2- Injectable urokinase solution should be prepared immediately before consumption, because the product does not contain any preservatives. Unused solution should also be discarded.
3- During the treatment with this drug, any unnecessary action for the patient should be avoided.
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