Cathflo Activase

Cathflo Activase is available as a sterile powder that is reconstituted with 2.2 mL of sterile water for injection to achieve a concentration of 1 mg/mL. The typical dosage is:

• 2 mg (2 mL) instilled into the blocked catheter.
• After instillation, the solution is allowed to dwell in the catheter for up to 2 hours to dissolve the clot.

If the catheter remains blocked after the first dose, a second dose may be administered.

Cathflo Activase is contraindicated in patients with:

• Active internal bleeding.
• Recent major surgery or trauma.
• Severe uncontrolled hypertension.
• Known hypersensitivity to alteplase or any component of the formulation.

Patients or healthcare providers using Cathflo Activase should be advised to:

• Ensure the solution is properly reconstituted and handled under sterile conditions.
• Do not force the alteplase into the catheter if there is resistance, as this may damage the catheter or cause complications.
• Monitor for signs of bleeding or other complications, particularly if the patient is at high risk for bleeding disorders.
• Notify a healthcare provider if the catheter remains blocked after two doses of Cathflo Activase.

• Mild bleeding or bruising at the catheter site.
• Localized discomfort at the catheter insertion point.

• Severe Bleeding: Although rare, serious bleeding can occur, especially in patients with pre-existing bleeding risks.
• Allergic Reactions: Symptoms such as rash, swelling, or difficulty breathing may indicate an allergic reaction and require immediate medical attention.

Bleeding Risk: As a thrombolytic, Cathflo Activase can increase the risk of bleeding, particularly in patients with bleeding disorders or those who have recently undergone surgery. Careful monitoring is required during and after administration.

Hypersensitivity Reactions: Although uncommon, allergic reactions may occur. Patients with known allergies to alteplase or any of its components should not receive this medication.

Catheter Damage: Forcing the alteplase solution into a catheter under high pressure can damage the catheter or dislodge the clot, potentially leading to complications like embolism.

Cathflo Activase may interact with medications that affect clotting or increase the risk of bleeding, including:

• Anticoagulants: Such as warfarin, heparin, or direct oral anticoagulants (DOACs).
• Antiplatelet Medications: Such as aspirin or clopidogrel.
• Non-steroidal anti-inflammatory Drugs (NSAIDs): Such as ibuprofen or naproxen, which may increase the risk of bleeding.

Patients should inform their healthcare provider of all medications and supplements they are taking to avoid potential interactions.

Alternative treatments for clearing occluded catheters include:

• Mechanical Thrombectomy: A procedure to manually remove clots from the catheter using special tools.
• Other Thrombolytic Agents: Such as reteplase or tenecteplase, though alteplase (Cathflo) is most commonly used for this purpose.