Aspirin
Adverse Effect: an increased risk of hemorrhagic complications Clinical Management: Aspirin use should be avoided in patients with ischemic stroke until thrombolysis is accomplished.
Dipyridamole
Adverse Effect: an increased risk of bleeding Clinical Management: Dipyridamole and streptokinase should be used concurrently only when the potential benefit outweighs the risk of bleeding. Observe patients for external bleeding and be alert for signs and symptoms of internal bleeding.
Indomethacin
Streptokinase has been shown to alter platelet function; therefore, concurrent use of drugs such as aspirin, indomethacin, dipyridamole, phenylbutazone, and other drugs known to significantly affect platelet integrity should be avoided
Phenylbutazone
Streptokinase has been shown to alter platelet function; therefore, concurrent use of drugs such as aspirin, indomethacin, dipyridamole, phenylbutazone, and other drugs known to significantly affect platelet integrity should be avoided
Tissue type plasminogen activator (t p a)
Adverse Effect: Increased risk of bleeding # Clinical Management: If coadministration of thrombolytic agents like Streptokinase is required close clinical and lab monitoring is required and the drug should be administered with caution.
Warfarin
Adverse Effect: An increased risk of bleeding Clinical Management: Extreme caution should be exercised in administration of streptokinase to patients on full oral anticoagulation with warfarin. This should be done only under the supervision of a physician experienced in the use of both drugs and the interpretation of the affected hematologic parameters. |