Heart Disease: Heart Disease Medicine: Thrombolytic Therapy (Clot Busters or Reperfusion Therapy)

Thrombolytic therapy, or clot buster drugs, are a type of heart medication given in the hospital through the veins (intravenous) to break up blood clots. Heart attack (caused by a blood clot in a coronary artery) and ischemic stroke (caused by a blood clot in an artery in the brain) are the two main conditions for which thrombolytic medications may be administered.

These powerful drugs are given:

• To prevent the ongoing damage of heart attacks.
• To prevent ongoing damage from ischemic stroke.
• To break up blood clots in other blood vessels in the body.

It is important to know the signs and symptoms of stroke and heart attack and call for emergency help (9-1-1 in most areas) right away if you or someone you are with is experiencing them. The faster you receive treatment with thrombolytic therapy (if appropriate), the quicker blood flow will be restored to the area and the greater the chance to prevent long-term damage, or even death.

There are many drugs that are used to break up clots, such as:

• Tissue plasminogen activator (TPA)
• Tenecteplase
• Alteplase
• Urokinase
• Reteplase
• Streptokinase

Who Shouldn't Take Clot Busters?

Please tell your doctor if you have any of the following conditions:

• Previous hemorrhagic stroke or bleeding in the brain
• Known cerebral vascular lesion or tumor
• Previous allergic reaction to a clot buster, or other allergies
• Active bleeding (excluding menses)
• Pregnancy
• Uncontrolled hypertension
• Bleeding disorder, or recent history of bleeding in any part of the body
• Severe liver disease
• Recent surgery (less than 2 weeks)
• Recent trauma, falls, or blows to the head within the past 3 months
• Recent CPR
• Active peptic ulcer

Should I Be Concerned About Food and Drug Interactions With Clot Busters?

Certain medications may increase your risk of bleeding if you are prescribed thrombolytic medications. Tell your doctor the names of all the medications, over-the-counter drugs, herbal medications, supplements or vitamins you are taking. Examples of these medications include:

• Blood thinners (warfarin, Coumadin)
• Anti-inflammatory medications or pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin)

Also tell the doctor if you have received any thrombolytic medications in the past six months. Some thrombolytic medications cannot be given a second time within a six-month period.

What Are the Side Effects?

As with any drug, there can be side effects with thrombolytic therapy. Notify your doctor if you notice:

• Bleeding or oozing from cuts or around the area of injection
• Allergic reaction
• Fever
• Low blood pressure
• Signs of bleeding from other sites within the body, such as blood in the urine, black tarry stools, nose bleeds, bleeding from the gums
• Any additional unusual symptoms

Ask your doctor or nurse if you have any questions about thrombolytic medications.

Reviewed by the doctors at The Cleveland Clinic Heart Center (200).