Thromboflux Special Precautions

It is recommended that I.M. injection be avoided for the first 24 hours.
Streptokinase infusion may cause hypotension as a result of rapid rate of infusion.
On termination of Streptokinase treatment, the patient should be given anticoagulants in an attempt to prevent re-thrombosis. Preferably heparin should be given, starting four hours after the end of thrombolysis and then an oral anticoagulant may be introduced after 24 hours of streptokinase discontinuation.
Following 7 to 10 days of treatment with streptokinase, the patient's anti-streptokinase antibodies titre increases considerably and return to normal only after up to  months. Normally a second treatment with streptokinase should not be considered within 6 months of the first. If a second treatment is considered necessary within 6 months the loading dose should be individually determined. The titrated initial dose should be calculated determining the smallest quantity of streptokinase required.
If heparin or oral anticoagulants have been given before commencing streptokinase therapy, further administration should be stopped. The streptokinase infusion can then be started after 4 hour.
Use in Elderly: Geriatric patients 75 years of age and older may be at increased risk of cerebral hemorrhage during streptokinase therapy.