# Alteplase

Source: https://onco.cc/drugs/alteplase/  
OnCo record `alteplase` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Alteplase is a clot-dissolving medicine. In cancer care its common use is a small dose left inside a port or central line that has stopped working because of a clot, to get blood flowing through it again.

## Summary

The Cathflo Activase label is "indicated for the restoration of function to central venous access devices as assessed by the ability to withdraw blood"; the Activase label covers acute ischaemic stroke, acute myocardial infarction and acute massive pulmonary embolism. People having chemotherapy through ports, PICC lines and tunnelled catheters are the main users of the catheter indication. A 2012 Cochrane review found very low-quality evidence from two single studies that alteplase 2 mg/2 mL may restore flow in lumens blocked by thrombosis, and called for better trials. The Genentech biologics licence (BLA 103172) was first approved on 13 November 1987.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-11-11
- Also known as: tPA; Cathflo; Actilyse
- Tags: supportive; generic; supportive-care-gaps-2026-11
- Brand: Activase / Cathflo Activase
- Modality: Thrombolytic (recombinant tissue plasminogen activator)
- Mechanism: Recombinant tissue plasminogen activator: converts plasminogen to plasmin, which breaks down the fibrin in a clot.
- Approvals: US 1987: Activase: acute ischaemic stroke, acute myocardial infarction and acute massive pulmonary embolism. Cathflo Activase: restoration of function to central venous access devices

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Alteplase
- US label (DailyMed): Cathflo Activase: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=91ecdef2-95ff-42dd-a31c-c8a09cab3ad9
- US label (DailyMed): Activase: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c669f77c-fa48-478b-a14b-80b20a0139c2
- van Miert et al., Interventions for restoring patency of occluded central venous catheter lumens (Cochrane Database Syst Rev 2012): https://doi.org/10.1002/14651858.CD007119.pub2

## Connected records

- drugs: [Urokinase](https://onco.cc/drugs/urokinase/)
- technologies: [Implanted ports for chemotherapy (port-a-cath, power-injectable, apheresis and intraperitoneal ports)](https://onco.cc/technologies/implanted-ports/), [Infusion pumps, ports, and ambulatory chemotherapy devices](https://onco.cc/technologies/infusion-devices-vascular-access/), [Peripherally inserted central catheters (PICC lines)](https://onco.cc/technologies/picc-lines/)
- terms: [Central venous access (port, PICC line)](https://onco.cc/terms/central-venous-access/)

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