Alteplase (international nonproprietary name) is a first-generation recombinant human tPA approved for general medical use in the United States in 1987 (Table 3.3). Developed and manufactured by Genentech Inc. (San Francisco, CA) it is sold under the tradename Activase. It displays an amino acid sequence identical to native human tPA, and, like native tPA, is glycosylated. Alteplase is indicated in the United States for:

1. The management of AMI in adults for the improvement of ventricular function following AMI, the reduction of the incidence of congestive heart failure, and the reduction of mortality associated with AMI.

2. The management of acute ischemic stroke in adults for improving neurological recovery and reducing the incidence of disability.

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