Urokinase: Brands, Price & Uses in Bangladesh

Urokinase is a thrombolytic (fibrinolytic) enzyme administered only in a hospital setting under close medical supervision. Its use is classified by strength of evidence as follows:

Established / FDA-approved use

• Acute massive pulmonary embolism (PE): Urokinase is indicated for the lysis of acute massive pulmonary emboli and pulmonary emboli accompanied by unstable hemodynamics, in adult patients where the diagnosis has been confirmed by objective means such as pulmonary angiography or lung scanning.

Established adjunct use

• Clearance of occluded central venous access devices (catheter clearance): Urokinase is used to restore patency to intravenous catheters and cannulae obstructed by clotted blood, allowing the device to be used again without removal.

Urokinase is not used for routine or minor venous thrombosis, and it is not an antibiotic or anti-infective agent. Its use always requires administration by, or under the direct supervision of, medical personnel experienced in thrombolytic therapy, in a facility equipped for continuous clinical and laboratory monitoring.

Dosing of Urokinase is highly specific to the indication, must be individualized, and is administered only by trained medical personnel using a calibrated infusion device with continuous monitoring. The following is a general summary; actual dosing must follow the treating physician's protocol and the current product labeling.

Concurrent anticoagulant (e.g., heparin) therapy is typically avoided during the Urokinase infusion itself and resumed afterward per protocol, due to additive bleeding risk (see Interactions).

The most important and frequent adverse reaction associated with Urokinase is bleeding, which can range from minor (e.g., oozing at puncture sites, bruising) to severe or fatal (e.g., intracranial hemorrhage, gastrointestinal or retroperitoneal bleeding). Other reported adverse effects include:

• Hypersensitivity/allergic reactions (rash, itching, flushing, bronchospasm; rarely anaphylaxis).
• Infusion-related reactions such as fever, chills, or transient hypoxia.
• Reperfusion arrhythmias as a blocked vessel reopens (see Precautions).
• Hypotension during infusion.
• Nausea.

Patients should seek immediate medical attention for unusual bruising, bleeding that does not stop, severe headache, sudden weakness, confusion, or difficulty breathing during or after treatment.