What is Streptokinase: Uses, Dosage, Side Effects and More

Streptokinase is a powerful clot-busting medication that can save lives during heart attacks and strokes. This enzyme works by dissolving dangerous blood clots that block your arteries, restoring blood flow to vital organs like your heart and brain. Doctors typically give this medication through an IV in emergency situations when every minute counts.

What is Streptokinase?

Streptokinase is a thrombolytic medication, which means it breaks down blood clots. It's an enzyme originally derived from certain bacteria that your body can use to dissolve clots that shouldn't be there. Think of it as a specialized tool that helps clear blocked pipes in your circulatory system.

This medication belongs to a class of drugs called fibrinolytics or "clot busters." Unlike blood thinners that prevent new clots from forming, streptokinase actively dissolves existing clots. It's been used in medicine for decades and has helped countless people recover from life-threatening conditions.

The medication comes as a powder that gets mixed with sterile water before being given to you. Healthcare providers administer it in carefully controlled hospital settings where they can monitor you closely throughout the treatment.

What is Streptokinase Used For?

Streptokinase treats serious conditions caused by blood clots that block important blood vessels. Your doctor might recommend this medication when you're experiencing a medical emergency where restoring blood flow quickly can prevent permanent damage to your organs.

The most common use is treating heart attacks, specifically a type called ST-elevation myocardial infarction (STEMI). When a blood clot blocks an artery feeding your heart muscle, streptokinase can dissolve that clot and restore blood flow before permanent heart damage occurs.

Doctors also use streptokinase for certain types of strokes caused by blood clots in brain arteries. However, this treatment must be given within a very specific time window to be both safe and effective.

Other conditions that may require streptokinase include severe blood clots in your lungs (pulmonary embolism) and blocked arteries in your legs or arms. Some doctors also use it to clear blocked catheters or shunts used for dialysis.

How Does Streptokinase Work?

Streptokinase works by activating your body's natural clot-dissolving system. It converts a protein in your blood called plasminogen into plasmin, which is your body's own clot-busting enzyme. This process helps break down the fibrin threads that hold blood clots together.

This medication is considered a strong, fast-acting treatment that can dissolve clots within hours. Unlike some newer clot-busting drugs, streptokinase affects your entire circulatory system, not just the area where the clot is located.

The enzyme works continuously while it's in your bloodstream, typically for several hours after administration. Your body gradually breaks down and eliminates the medication, and your normal clotting ability returns within 12 to 24 hours.

How Should I Take Streptokinase?

You won't take streptokinase at home - this medication is only given in hospitals by trained medical professionals. The treatment involves receiving the medication through an intravenous (IV) line, usually in your arm, or sometimes directly into the blocked artery through a thin tube called a catheter.

Before treatment begins, your medical team will insert an IV line and may give you other medications to help prevent allergic reactions. You'll need to lie still during the infusion, which typically takes 30 minutes to an hour, depending on your specific condition.

During treatment, nurses will monitor your vital signs closely and watch for any signs of bleeding or allergic reactions. You won't need to eat or drink anything special before the procedure, but your stomach should be empty if possible to reduce the risk of complications.

The exact dose and duration depend on your weight, the type of clot being treated, and your overall health condition. Your doctor will calculate the precise amount you need based on these factors.

How Long Should I Take Streptokinase For?

Streptokinase is typically given as a single treatment session, not as an ongoing medication. Most people receive the full dose over 30 to 60 minutes, depending on what condition is being treated and how your body responds.

For heart attacks, the treatment usually lasts about 60 minutes. For other conditions like pulmonary embolism, it might take longer - sometimes up to 24 hours for severe cases. Your medical team will determine the exact duration based on your specific situation.

After the initial treatment, you won't continue taking streptokinase. However, you'll likely start other medications to prevent new clots from forming, such as aspirin or other blood thinners. These follow-up medications help maintain the benefits of the clot-busting treatment.

What Are the Side Effects of Streptokinase?

Like all powerful medications, streptokinase can cause side effects, though not everyone experiences them. The most serious concern is bleeding, since the medication affects your blood's ability to clot normally.

Here are the more common side effects you might experience during or after treatment:

• Bleeding from injection sites, cuts, or surgical wounds
• Bruising more easily than usual
• Nausea or mild stomach upset
• Low-grade fever
• Headache
• Muscle or joint aches

Most of these effects are temporary and resolve within a day or two as the medication leaves your system.

More serious side effects require immediate medical attention, though they're less common:

• Severe bleeding that won't stop
• Blood in urine or stool
• Severe headache or confusion
• Difficulty breathing or chest pain
• Signs of allergic reaction like rash, swelling, or difficulty swallowing
• Sudden severe abdominal pain

Your medical team monitors you closely during and after treatment to catch any complications early. They're prepared to manage these side effects if they occur.

Some rare but serious complications include bleeding in the brain (intracranial hemorrhage), which occurs in about 0.5% of patients. Severe allergic reactions are also uncommon but can happen, especially if you've received streptokinase before.

Who Should Not Take Streptokinase?

Streptokinase isn't safe for everyone, and your doctor will carefully review your medical history before recommending this treatment. Certain conditions make the bleeding risks too high compared to the potential benefits.

You shouldn't receive streptokinase if you have any of these conditions:

• Active bleeding anywhere in your body
• Recent surgery (within 2-4 weeks)
• Recent head injury or stroke
• Known bleeding disorders
• Severe high blood pressure that's not controlled
• History of brain aneurysm or arteriovenous malformation

These conditions significantly increase your risk of dangerous bleeding complications that could be life-threatening.

Your doctor will also be very cautious about using streptokinase if you have:

• Previous treatment with streptokinase (increases allergy risk)
• Recent strep throat or infection
• Pregnancy
• Severe liver or kidney disease
• Recent dental work or tooth extraction
• Diabetic retinopathy with bleeding

In these situations, your doctor might choose a different clot-busting medication or treatment approach that's safer for your specific circumstances.

Streptokinase Brand Names

Streptokinase is available under several brand names, though the generic version is most commonly used in hospitals. The most recognized brand name is Streptase, which was one of the first commercially available forms of this medication.

Other brand names include Kabikinase and Streptokinase-INN, though availability varies by country and healthcare system. In many hospitals, you'll receive the generic version, which is just as effective as the brand-name products.

The medication is the same regardless of the brand name - all contain the same active enzyme that dissolves blood clots. Your healthcare team will use whichever version is available at your hospital.

Streptokinase Alternatives

Several other clot-busting medications can work as alternatives to streptokinase, each with their own advantages and considerations. Your doctor might choose a different option based on your specific situation and medical history.

Alteplase (tPA) is a newer medication that's often preferred for strokes because it can be given within a longer time window and may cause fewer allergic reactions. However, it's more expensive than streptokinase.

Reteplase and tenecteplase are similar to alteplase but can be given more quickly as a bolus injection rather than a continuous infusion. These might be chosen in situations where speed is critical.

For some conditions, doctors might use mechanical clot removal instead of medications. This involves threading a small device through your blood vessels to physically remove the clot, which can be effective when medications aren't suitable.

Is Streptokinase Better Than Alteplase?

Both streptokinase and alteplase are effective clot-busting medications, but they each have different strengths depending on your situation. The "better" choice depends on factors like timing, cost, your medical history, and the specific type of clot being treated.

Streptokinase has been used longer and costs significantly less than alteplase. It's very effective for heart attacks when given within the first few hours, and many studies show similar outcomes to newer medications when used appropriately.

Alteplase may be preferred for strokes because it can be given within a longer time window (up to 4.5 hours versus 3 hours for streptokinase) and typically causes fewer allergic reactions. It's also more clot-specific, meaning it focuses more on the problem clot rather than affecting your entire clotting system.

Your doctor will consider your specific circumstances, including how much time has passed since your symptoms started, your risk factors for bleeding, and any previous treatments you've received. Both medications can be life-saving when used in the right situation.