How the interaction occurs:
Both alteplase and anticoagulants decrease your body's ability to make blood clots.
What might happen:
You may experience an increased chance for bleeding including bleeding from your gums, nosebleeds, unusual bruising, dark stools, or bleeding from injection sites.
What you should do about this interaction:
Alteplase is a medicine that is used in a hospital to treat strokes, heart attacks, and blood clots in the lungs. If you need to be treated for a stroke and you use an anticoagulant (a "blood thinner"), your doctor may want to use a different medicine instead of alteplase. If you need to be treated for a heart attack or a blood clot in your lungs and you use an anticoagulant, your doctor will need to monitor you more closely. Be sure to let your healthcare professionals (e.g. doctor or pharmacist) and your family members know that you are taking an anticoagulant, so that emergency room personnel can treat you properly.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.
1.Activase (alteplase, recombinant) US prescribing information. Genentech, Inc. April, 1999.
2.Prabhakaran S, Rivolta J, Vieira JR, Rincon F, Stillman J, Marshall RS, Chong JY. Symptomatic Intracerebral Hemorrhage Among Eligible Warfarin-Treated Patients Receiving Intravenous Tissue Plasminogen Activator for Acute Ischemic Stroke. Arch Neurol 2010 Mar 8.