Intravenously drip, intraarterially, intracoronary. Intravenously (to dissolve the powder, gently mix, avoiding foaming, with 5 ml of a 0.9% solution of sodium chloride or water for injection, with Ringer's solution).
For short-term lysis in thrombosis of peripheral arteries or veins, an initial dose of 250,000 IU is intravenously dripped for 30 minutes, followed by maintenance doses of 1.5 million ME each hour for 6 hours, the maximum dose per cycle is 9 million ME. It is possible to repeat the 6 hour introduction on the next day, which takes place no later than 5 days after the first course. In the case of prolonged thrombolysis - 250 thousand ME intravenously drip for 30 minutes, then 1 million IU / h in the form of infusion lasting from 12 hours to 3-5 days (no more). If necessary, continue therapy after a break and with a possible replacement for another homologous thrombolytic.
For coronary thrombosis, 1.5 million IU for 60 minutes, followed by the administration of heparin at a dose of 1,000 IU / h.
The effect is monitored by determining thrombin or partial thrombollastine time. For long-term lysis in peripheral vascular thrombosis 250,000 IU are administered for 30 minutes. The maintenance dose is 100 thousand IU / h. This achieves a 2-4-fold increase in thrombin time 6-8 hours after the onset of lysis. The concentration of fibrinogen in the plasma should not be less than 1 g / l. If after a few hours the thrombin time increases more than 4 times, the maintenance dose should be reduced by a factor of 2 and applied until,The thrombin time index again does not stabilize in the above interval.
For lysis of the intracoronary thrombus, intracoronary injection is introduced, with the help of a catheter 20,000 ME, then 2-4 thousand IU / mi, a total dose of 140,000 IU, 30-40 minutes or 250-300 thousand ME for 30-60 min. The administration does not stop earlier than 1 hour, although recanalization may develop more rapidly.
For the prevention of retrombosis appoint heparin. Duration of treatment should not exceed 5 days.
Patients with acute, subacute, chronic peripheral thrombosis and thromboembolism are administered 1-2 thousand IU at intervals of 3-5 minutes. Duration and quantity depend on the localization and depth of occlusion of the vessel, maximal - 120 thousand ME for 3 hours. It is possible to perform simultaneous angioplasty.
Local thrombolysis in acute, subacute and chronic thrombosis and thromboembolism of peripheral arteries intraarterially, at a dose of 1-2 thousand ME at intervals of 3-5 minutes until the effect is achieved. The total dose should not exceed 120 thousand, ME.
For deep vein thrombosis and pulmonary embolism, intravenous drip, 250,000 IU for 30 minutes, then 100,000 IU / h for 24-72 hours in accordance with pathology.
To restore the patency of the cannula - 100-250 thousand.ME in 2 ml of sodium chloride solution, slowly into each occluded end. The procedure is carried out for 2 hours, followed by aspiration of contents from the cannula.