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Streptokinase: Brands, Price & Uses in Bangladesh
Streptokinase is a thrombolytic (fibrinolytic) enzyme used exclusively in emergency, hospital-based settings under continuous medical supervision.
About Streptokinase
Indications of Streptokinase
Streptokinase is a thrombolytic (fibrinolytic) enzyme used exclusively in emergency, hospital-based settings under continuous medical supervision. It is indicated for the following conditions:
Established/guideline-supported uses
- Acute ST-elevation myocardial infarction (STEMI): to reduce infarct size, preserve left ventricular function, and reduce mortality when administered early after symptom onset.
- Acute massive pulmonary embolism: with hemodynamic instability, to dissolve the obstructing thrombus.
- Deep vein thrombosis (DVT): extensive acute proximal DVT, in appropriately selected patients.
- Acute arterial thromboembolism/occlusion: of a native artery or bypass graft.
- Clearance of occluded arteriovenous (AV) cannulae: used for dialysis access, when the cannula is blocked by clotted blood and other methods have failed.
Notes on use
Streptokinase therapy is typically followed by anticoagulation (e.g., heparin) to prevent re-thrombosis. It requires strict patient selection based on bleeding risk and time since symptom onset, and is administered only by trained personnel in a hospital or emergency care setting with facilities for continuous monitoring and management of bleeding complications.
Dosage & Administration of Streptokinase
Streptokinase is administered only by intravenous or intracoronary infusion by trained healthcare professionals in a hospital or emergency care setting, with continuous monitoring of vital signs, bleeding, and (where feasible) coagulation status.
| Indication | Dose |
|---|---|
| Acute myocardial infarction (IV) | 1,500,000 IU infused intravenously over 60 minutes |
| Acute myocardial infarction (intracoronary) | 20,000 IU bolus followed by 2,000 IU/minute for up to 60 minutes |
| Pulmonary embolism | Loading dose of 250,000 IU IV over 30 minutes, then 100,000 IU/hour for 24 hours |
| Deep vein thrombosis / arterial thromboembolism | Loading dose of 250,000 IU IV over 30 minutes, then 100,000 IU/hour for 24-72 hours, guided by clinical and laboratory response |
| Occluded arteriovenous cannula | 250,000 IU in 2 mL solution instilled slowly into each occluded limb of the cannula; clamp for 2 hours, then aspirate and flush |
Dosing must be individualized by the treating physician based on the indication, patient weight, bleeding risk, and clinical response. Concurrent or subsequent anticoagulant therapy is often required and should be guided by a specialist.
Side Effects of Streptokinase
The most significant adverse effect of Streptokinase is bleeding, which can range from minor (bruising, oozing at puncture sites) to severe or life-threatening (gastrointestinal, genitourinary, retroperitoneal, or intracranial hemorrhage).
Other reported adverse effects
- Allergic/anaphylactoid reactions: rash, itching, flushing, fever, chills, breathing difficulty, and rarely anaphylaxis (related to antibody formation against this bacterial protein)
- Hypotension, particularly during rapid infusion
- Reperfusion arrhythmias after successful clot dissolution in myocardial infarction
- Nausea, vomiting
- Musculoskeletal or lower back pain
- Headache
Patients are monitored closely during and after infusion for these effects; serious bleeding requires immediate discontinuation and appropriate emergency management.
Contraindications of Streptokinase
Streptokinase is contraindicated in patients with:
- Known hypersensitivity to Streptokinase or any component of the formulation
- Active internal bleeding
- History of hemorrhagic stroke, or stroke of unknown origin at any time, or ischemic stroke within the preceding 2-3 months
- Recent intracranial or intraspinal surgery or trauma, or known intracranial neoplasm, arteriovenous malformation, or aneurysm
- Known bleeding diathesis or severe uncontrolled coagulopathy
- Severe uncontrolled hypertension
- Suspected aortic dissection
Only true absolute contraindications are listed here; conditions that raise bleeding risk without being absolute (e.g., recent major surgery, recent trauma, pregnancy) are discussed under Precautions and Warnings and require careful individualized risk-benefit assessment.
Frequently Asked Questions about Streptokinase
What is Streptokinase used for?
Streptokinase is a thrombolytic (clot-dissolving) medicine used in hospital emergency settings to treat acute heart attack (myocardial infarction), massive pulmonary embolism, certain cases of deep vein thrombosis and arterial blood clots, and to clear blocked dialysis access lines.
Is Streptokinase safe during pregnancy?
Streptokinase should be used in pregnancy only if the potential benefit clearly outweighs the potential risk to the fetus, such as placental bleeding, because well-controlled studies in pregnant women are lacking. It is generally reserved for life-threatening emergencies and should only be given under close physician supervision.
Can Streptokinase be given more than once?
Repeat use of Streptokinase, especially within 6 months to 2 years of a previous dose, may be less effective and can increase the risk of allergic or anaphylactoid reactions because the body develops antibodies against it. If retreatment is needed within this period, doctors generally prefer a different thrombolytic agent.
What are the main risks of Streptokinase?
The most serious risk of Streptokinase is bleeding, which can range from minor bruising to severe, life-threatening bleeding including intracranial hemorrhage (bleeding in the brain). It also carries a risk of allergic reactions. Because of these risks, it is given only in a hospital setting with continuous monitoring.
Who should not receive Streptokinase?
Streptokinase must not be given to people with active internal bleeding, a history of hemorrhagic stroke or stroke of unknown cause, recent brain or spinal surgery or trauma, a known bleeding disorder, severe uncontrolled high blood pressure, or suspected aortic dissection.
Can I take Streptokinase at home?
No. Streptokinase is administered only by intravenous or intracoronary infusion by trained healthcare professionals in a hospital or emergency care setting with continuous monitoring; it is not available as a take-home or self-administered medicine.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.