Recombinant Tissue Plasminogen Activator and Stroke Treatment

Recombinant tissue plasminogen activator (TPA) is a medicine that can dissolve blood clots. This treatment may be used for a person who is having a stroke caused by clots that block blood flow to the brain (ischemic stroke). Recombinant TPA can help treat a stroke if given early and under the right conditions. Recombinant TPA does not lessen the chances of a stroke happening in the future.

Recombinant TPA is typically given through an IV access tube that is put into a vein. Before providing this treatment, your health care provider will carefully consider whether this treatment is appropriate for you. Many people cannot receive this medicine for a variety of reasons, such as age, other medical conditions, and the onset, duration, or severity of stroke symptoms. To be effective, this medicine must be given within 3 to 4½ hours (depending on your age) after the symptoms begin.


  • Any allergies you have.  

  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.

  • Any blood disorders you have.

  • History of blood clots (thrombophlebitis).  

  • Previous surgeries you have had.  

  • Broken bones or other injuries in the past 14 days.  

  • Stroke within the last 3 months.  

  • History of a hemorrhagic stroke.  

  • Head injury in the last 3 months.  

  • High blood pressure.  

  • Blood in the urine (hematuria) in the last 21 days.  

  • Brain tumors.  

  • Recent heart attack.  

  • Problems with diabetes.  

  • Abnormality (such as aneurysms or malformations) of the blood vessels inside the head.  

  • Possibility of pregnancy, if this applies.  

  • Any other serious medical condition.  


  • Bleeding into the brain.

  • Bleeding in other parts of the body.  


  • Your health care provider will perform a physical exam and take a detailed medical history to determine if recombinant TPA is a treatment option. It is very important to identify when your stroke symptoms started. This will help determine if recombinant TPA might help you.

  • Your blood pressure, pulse, and breathing rate (vital signs) will be monitored closely.  

  • A CT scan of your head will be done to make sure there is no bleeding.  

  • You may be given medicines to adjust blood pressure if needed.  

  • Blood tests will be done.  


Recombinant TPA is typically given through an IV access tube that is put into one of your veins. In some cases, this medicine may be given directly into the affected artery through a thin, flexible tube (catheter) usually inserted through the groin. While you are receiving the medicine, your vital signs will be monitored closely, and you may be given medicine to control blood pressure if needed. Frequent tests of your brain function will be performed. If bleeding occurs from recombinant TPA, the infusion will be stopped and appropriate therapy will be started.


  • You will be observed very closely, usually in an intensive care unit (ICU) or a stroke unit.  

  • You may need to stop taking other medicines that affect how your blood clots for 24 hours after getting recombinant TPA.  

  • A CT scan of the head may be done 24 hours after the procedure.  

  • Your brain function will be checked often during your stay in the hospital.  

  • It may take several days, weeks, or even months to fully determine how you responded to the recombinant TPA treatment. This is the case with any type of stroke therapy.