Contraindication/Precautions

Contraindicated in:

• Active internal bleeding

• History of cerebrovascular accident

• Recent (within 2 months) intracranial or intraspinal injury or trauma

• Intracranial neoplasm, arteriovenous malformation, or aneurysm

• Severe uncontrolled hypertension

• Known bleeding tendencies

• Hypersensitivity; cross-sensitivity with anistreplase and streptokinase may occur

• Recent (within 10 days) major surgery, trauma, GI or GU bleeding

• Left heart thrombus

• Severe hepatic or renal disease

• Hemorrhagic ophthalmic conditions

• Septic phlebitis

• Previous puncture of a noncompressible vessel

• Subacute bacterial endocarditis or acute pericarditis

• Recent streptococcal infection or previous therapy with anistreplase or streptokinase (within 5 days–6 mo); may produce resistance because of antibody formation; increased dosage requirements may be encountered (anistreplase and streptokinase only)

• Previous therapy with streptokinase or anistreplase (within 12 months); may produce resistance because of antibody formation

• OB: Lactation: Pedi: Safety not established

• Geri: Increased risk of intracranial bleeding

• Patients receiving warfarin therapy

• OB: Early postpartum period (10 days)

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