Alteplase and Enoxaparin: Drug Interaction Guide
Quick answer: This is a major interaction — avoid combining Alteplase and Enoxaparin unless specifically directed by your doctor.
How Alteplase interacts with Enoxaparin
Concurrent fibrinolytic and therapeutic-dose low-molecular-weight heparin produce additive impairment of haemostasis and substantially increase major and intracranial bleeding.
What you should do
Avoid therapeutic-dose enoxaparin within 24 hours of alteplase administration; prophylactic doses may be used for VTE prevention after this interval.
Key facts
Severity
Major — avoid combination
Mechanism
Concurrent fibrinolytic and therapeutic-dose low-molecular-weight heparin produce additive impairment of haemostasis and...
Action
Avoid therapeutic-dose enoxaparin within 24 hours of alteplase administration; prophylactic doses may be used for VTE pr...
Frequently asked questions
Can I take Alteplase and Enoxaparin together?
No — this combination should generally be avoided. Avoid therapeutic-dose enoxaparin within 24 hours of alteplase administration; prophylactic doses may be used for VTE prevention after this interval.
What is the severity of this interaction?
The interaction between Alteplase and Enoxaparin is classified as Major — avoid combination. Concurrent fibrinolytic and therapeutic-dose low-molecular-weight heparin produce additive impairment of haemostasis and substantially increase major and intracranial bleeding.
What should I do if I'm prescribed both?
Avoid therapeutic-dose enoxaparin within 24 hours of alteplase administration; prophylactic doses may be used for VTE prevention after this interval. Always consult your prescribing clinician — do not stop or change medications without medical guidance.
Last reviewed: by iMedic Medical Editorial Team. Our editorial process.