EKOS alteplase stability

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Rachel Durham
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Joined: 02/17/2020 - 22:00
EKOS alteplase stability

Good morning.

We recently started using EKOS for pharmaco-mechanical thrombolysis. The cardiologist indicated that a typical dose would be 6 mg/50 ml over 6 hours but he may want more over a longer period of time depending on the situation. In our EHR, we built 2 options: 6 mg/50 ml and 12 mg/100 ml and a typical rate would be 1 mg/hr per catheter. For those pharmacies compounding alteplase (using Cathflo), what BUD are you assigning the compound? The package labeling for Cathflo says this:

Storage: Use immediately after reconstitution. The solution may be used for intracatheter instillation within 8 hours following reconstitution when stored at 2 to 30 degrees C (36 to 86 degrees F).
I am not sure if this should be applied to the compound for EKOS. If I reference this stability information, does it mean that it needs to start within 8 hours or that it needs to be infused by the end of 8 hours?

Thank you VERY MUCH for any information on how this is being handled at other hospitals!

Rachel Durham