EKOS alteplase stability

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to jgold@ismp.org

2 posts / 0 new
Last post
Rachel Durham
Rachel Durham's picture
Last seen: 3 weeks 5 days ago
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