Alteplase (Actilyse) Stroke Dose Calculator

Clinical context

Clinical scope This calculator applies only to intravenous alteplase for an eligible patient with acute ischemic stroke. It calculates 0.9 mg/kg (maximum 90 mg): 10% as a bolus over 1 minute, followed by the remaining 90% over 60 minutes. It does not calculate alteplase regimens for pulmonary embolism, myocardial infarction, or catheter clearance. Safety Use within a current stroke pathway after confirming the treatment window, brain imaging, blood-pressure requirements, and all inclusion and exclusion criteria. Active internal bleeding and intracranial hemorrhage are contraindications. Recent surgery, trauma, anticoagulant exposure, coagulopathy, and uncontrolled hypertension require protocol-based assessment. Orolingual angioedema can occur, particularly with concomitant ACE-inhibitor treatment. Monitoring Perform frequent neurological and blood-pressure assessments during and after treatment. New severe headache, acute hypertension, nausea or vomiting, or neurological deterioration requires immediate evaluation for intracranial hemorrhage. Avoid unnecessary invasive procedures and follow the local post-thrombolysis antithrombotic protocol.