Urokinase

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Urokinase; Belgium: Actosolv; Cyprus: Ukidan; Czech Republic: Rheotromb; France: Actosolv; Germany: Corase, Rheotromb, Urokinase; Greece: Abbokinase, Kinase, Ukidan, Urochinasi; Hungary: Rheotromb, Ukidan; Italy: Actosolv, Persolv, Ukidan, Urokinase; Luxembourg: Abbokinase, Actosolv, Alphakinase, Urokinase; Netherlands: Medacinase, Urokinase; Poland: Urokinaza; Spain: Urokinase, Uroquidán; UK: Kinase.

Asia

Japan: Uronase.

Drug combinations

Chemistry

Urokinase: C~1376~H~2145~N~383~O~406~S~18~. Mw: 31126.50. A plasminogen activator isolated from human sources. Kinase (enzyme-activating), uro-; CAS-9039-53-6 (1965).

Urokinase Alpha: Mw: approx. 54000.01 (SDS gels). Urokinase (enzyme-activating)(human clone pA3/pD2/pF1 high-molecular-weight isoenzyme protein moiety). CAS-99821-47-3 (1997).

Pharmacologic Category

Antithrombotic Agents; Thrombolytic Agents; Enzymes. (ATC-Code: B01AD04).

Mechanism of action

Promotes thrombolysis by directly activating plasminogen to plasmin, which degrades fibrin, fibrinogen, and other procoagulant plasma proteins.

Therapeutic use

Thrombolytic agent for lysis of acute massive pulmonary emboli or pulmonary emboli with unstable hemodynamics.

Pregnancy and lactiation implications

Not found to be teratogenic in animal studies; unknown if it crosses human placenta. Use during pregnancy only if clearly needed. Excretion in breast milk unknown (use caution).

Unlabeled use

Treatment of recent severe or massive deep vein thrombosis, and occluded I.V. or dialysis cannulas. Peripheral arterial occlusive disease.

Contraindications

Hypersensitivity to urokinase or any component of the formulation. Active internal bleeding. Recent (within 2 months) CVA, intracranial surgery or intraspinal surgery. Recent trauma (including cardiopulmonary resuscitation). Intracranial neoplasm, arteriovenous malformation, or aneurysm. Bleeding diathesis. Severe uncontrolled arterial hypertension.

Warnings and precautions

Increased risk of bleeding (fatal hemorrhage reported). Cholesterol embolization reported rarely with use of thrombolytics, usually associated with invasive vascular procedures and/or anticoagulant therapy. Hypersensitivity reactions, including fatal anaphylaxis (rare), bronchospasm, orolingual edema, and urticaria reported. Infusion reactions (e.g. chills, rigor, hypoxia, hyper-/hypotension, tachycardia) may occur. Use with caution in patients receiving oral anticoagulants or platelet inhibitors (increased risk of bleeding). Concurrent heparin anticoagulation may contribute to bleeding. Formulated in human albumin (theoretical risk of transmitting infectious agents).

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