FOCUS ON RETEPLASE - A NEWLY APPROVED 3RD-GENERATION THROMBOLYTIC AGENT FOR THE TREATMENT OF ACUTE MYOCARDIAL-INFARCTION

Reteplase (Retavase) is a genetically engineered third-generation thro mbolytic agent recently approved by the FDA for the treatment of acute myocardial infarction (AMI). Its several domain modifications of the tissue-type plasminogen activator gene have given reteplase enhanced p harmacologic properties, including a threefold-longer half-life, which allows for a simplified thrombolytic dosing regimen. Reteplase is giv en as a 10-U intravenous bolus followed 30 minutes later by a second 1 0-U bolus. Several comparative trials have shown reteplase to be as ef fective and well tolerated as streptokinase and to achieve more rapid, complete, and sustained thrombolysis than alteplase. As with other th rombolytics, the most serious adverse effect reported with reteplase i s bleeding. Reteplase may offer a useful alternative to existing throm bolytic therapy in AMI.