tPA (Alteplase) Dosing for Ischemic Stroke Calculator

tPA (Alteplase) Dosing Calculator
kg
Total Dose:–
IV Bolus (10%):–
IV Infusion over 60 min (90%):–
tPA Dosing for Ischemic Stroke
0.9 mg/kg (max 90 mg). 10% given as IV bolus over 1 minute. Remaining 90% infused over 60 minutes. Must be within treatment window. Check all contraindications before administration.
Calculates alteplase dosing for ischemic stroke.

Why Use

Because of the time-sensitive, high-stress, infrequent nature of ischemic stroke cases receiving tPA, there is risk for medication error. Using a calculator to double check dosing prior to administration can reduce the risk of error.

When to Use

This calculator is intended solely for calculating the alteplase (tPA) dose for ischemic stroke. It does not apply to dosing for acute coronary syndromes or pulmonary embolism.

Formula

tPA dosing is calculated by the following: Dose, mg = 0.9*(Weight, kg) Administer 10% of the total dose as an initial IV bolus over 1 minute and the remainder infused over 60 minutes. Waste, mg = 100 - (Bolus, mg + Infusion, mg) Note: Total maximum dose is 90 mg.

Pearls / Pitfalls

Remember that up to 20 mL (20 mg) tPA will remain in the pump tubing regardless of the method of preparation (withdrawing waste from vial before administration or leaving waste volume in the vial). Standard practice is to infuse up to 50 mL of 0.9% sodium chloride at the same rate after the tPA vial is empty.

Advice

Administer tPA when indicated .

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