Alteplase Dose Reference Calculator — Stroke & PE

About the Alteplase Dose Reference Calculator — Stroke & PE

Tissue plasminogen activator (tPA, alteplase) is used in acute ischemic stroke and is also used in massive pulmonary embolism. For stroke, the common reference dose is weight-based (0.9 mg/kg, maximum 90 mg).

This page stays focused on that dosing arithmetic. It helps you cross-check the weight-based stroke total and the common PE reference total without treating the calculator like a stand-alone thrombolysis pathway.

When This Page Helps

Alteplase dosing is one of the easiest parts of the review to calculate but one of the hardest to do calmly under time pressure. This page keeps the weight-based math and total-dose reference together so the arithmetic can be cross-checked quickly without turning the page into a treatment pathway.

How to Use the Inputs

1. Select the indication (acute ischemic stroke or massive PE).
2. Enter the patient's body weight in kilograms.
3. Review the calculated total dose shown on the page.
4. Use the result as reference math only, not as a stand-alone treatment workflow.

Example Calculation

Tips & Best Practices

• Use actual body weight rather than ideal body weight for the stroke dose, and keep the 90 mg cap in view.
• Treat the result as a dose cross-check, not as a replacement for pharmacy verification or imaging review.
• The result is only dose arithmetic; timing and eligibility still belong to the formal clinical review.
• Stroke and PE use different reference dosing contexts even though both involve alteplase.
• If the clinical picture changes during treatment, bedside reassessment matters more than any calculator output.

What This Page Does Well

This page is strongest as a dosing worksheet. It makes the weight-based stroke math explicit and keeps the total-dose reference visible so users do not need to redo the arithmetic under pressure.

What It Does Not Replace

Alteplase review still requires imaging, exclusion review, neurologic assessment, and the process used by the treating service. The page therefore works best as a math cross-check once the team has already identified which formal process applies.

Why the Context Changes by Indication

Stroke and pulmonary embolism use alteplase differently. The same drug name appears in both settings, but the timing, exclusions, and monitoring expectations are not interchangeable.

Frequently Asked Questions

• Why is the stroke dose different from the PE dose?

  Stroke commonly uses 0.9 mg/kg (max 90 mg), while PE references often use a fixed 100 mg total. The difference reflects the disease setting, trial history, and pathway assumptions behind each indication rather than a single universal alteplase formula.

• Why does this page focus on dose math instead of eligibility?

  Eligibility depends on imaging, timing, exclusion review, and the formal process being used by the treating team. This page stays focused on the arithmetic because the total dose is one of the easiest parts to cross-check without turning the calculator into a treatment workflow.

• What about tenecteplase?

  Tenecteplase (TNK) is increasingly used off-label for stroke because it is given as a single bolus and has a longer half-life. Some institutions now use it in place of alteplase, but actual drug choice still depends on the local workflow.

• Why doesn't this page ask about blood pressure or symptom onset?

  Those details belong to eligibility review, not dose arithmetic. This page stays focused on the math so it can be used as a reference cross-check without pretending to replace the full alteplase workflow.

• What about mechanical thrombectomy?

  Large-vessel-occlusion workflows often include thrombectomy review out to 24 hours in selected patients, but that still depends on imaging and local stroke workflow. This page is only a dosing worksheet and does not decide whether alteplase or thrombectomy should be used.

• Why doesn't this page estimate bleeding risk?

  Bleeding-risk review depends on far more than a few bedside variables. Imaging findings, exclusion criteria, timing, clinical context, and the exact process being used all matter, so this page leaves that assessment outside the calculator.