Indications & Dose: MYOCARDIAL INFARCTION Acute Emergency therapy IV Adult Initially 15mg (initiated within 6h of symptom onset) followed by 50mg over 30min, then 35mg over 1h max 100mg over 1.5h, <65kg: Initially 15mg, followed by 0.75mg/kg over 30min then 0.5mg/kg over 1h, max 100mg over 1.5h | Acute Emergency therapy IV Adult Initially 10mg (within 6–12h of symptom onset) followed by 50mg over 1h, then 4 inf each of 10mg over 30min (total dose 100mg over 3h) max 1.5mg/kg (patients <65kg) | PULMONARY EMBOLISM Acute Emergency therapy IV Adult Initially 10mg over 1–2min followed by inf 90mg over 2h max 1.5mg/kg (patients <65kg) | STROKE Acute Emergency therapy IV Adult 900µg/kg over 1h (administer 10% of the initial dose by inj & remaining by inf) max 90mgTreatment must begin within 3h of symptom onset

Precautions: Risk of bleeding, external chest compression, elderly, HTN, atrial fibrillation, drugs increases the risk of bleeding

ADR: Serious: Hypotension, GI/GU hemorrhage, Others: rash, nausea, vomiting, fever, bruising

DDI: Serious Aspirin increases risk of bleeding with drug, Dabigatran/Argatroban/Lepirudin increases risks of bleeding with drug

Monitor: Acute ischemic stroke, BP and ECG changes