The Basics
What is Alteplase?
Used to treat heart attacks, strokes, and blood clots.
Brand names for Alteplase
Activase
How Alteplase is classified
Enzymes, Blood Coagulation Factors, Plasminogen Activators
Alteplase During Pregnancy
Alteplase pregnancy category
Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Alteplase while pregnant
Activase is embryocidal in rabbits when intravenously administered in doses of approximately two times (3 mg/kg) the human dose for AMI. No maternal or fetal toxicity was evident at 0.65 times (1 mg/kg) the human dose in pregnant rats and rabbits dosed during the period of organogenesis. There are no adequate and well-controlled studies in pregnant women.
Taking Alteplase While Breastfeeding
What are recommendations for lactation if you're taking Alteplase?
Tissue plasminogen activator (tPA), which is identical to alteplase, is a normal component of human colostrum and breastmilk.[1][2][3] Levels in milk are highest in colostrum and decrease rapidly during the first week, followed by a sower decrease over time.[2][3] Because alteplase is a large protein molecule with a molecular weight of about 59,000, absorption is unlikely because it is probably destroyed in the infant’s gastrointestinal tract. No information is available on the clinical use of alteplase during breastfeeding. Until more data become available, alteplase should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.
Maternal / infant drug levels
Tissue plasminogen activator (tPA), which is identical to alteplase, is a normal component of human colostrum and breastmilk.[1][2][3] Levels in milk are highest in colostrum and decrease rapidly during the first week, followed by a sower decrease over time.[2][3] Because alteplase is a large protein molecule with a molecular weight of about 59,000, absorption is unlikely because it is probably destroyed in the infant’s gastrointestinal tract. No information is available on the clinical use of alteplase during breastfeeding. Until more data become available, alteplase should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant.
Possible effects of Alteplase on milk supply
Relevant published information was not found as of the revision date.
Possible alternatives to Alteplase
None listed
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Heegaard CW, Larsen LB, Rasmussen LK, Hojberg KE, Petersen TE, Andreasen PA. Plasminogen activation system in human milk. J Pediatr Gastroenterol Nutr. 1997;25:159-66. PMID: 9252902
2. Ishii A, Yamada S, Yamada R, Hamada H. Determination of t-PA activity and t-PA antigen in human milk. J Perinat Med. 1992;20:203-7. PMID: 1453294
3. Marshall JM, Rees MC, Cederholm-Williams SA. Identification of t-PA as the major active plasminogen activator in human milk. Thromb Haemost. 1986;55:279-81. PMID: 3087004
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
