| Urokinase, Abbokinase
Urokinase (Abbokinase) is the fibrinolytic agent most familiar to interventional radiologists and the one that has been used most often for peripheral intravascular thrombus and occluded catheters. Recently, urokinase was made available once again from the manufacturer. After some years hold from the market due to manufacturer issues with the FDA, it has been reintroduced. The package insert was revised and since then has an indication only for pulmonary embolism. During the time this drug was not available, the FDA encouraged the off-label use of reteplase and alteplase for local-regional lysis of venous and arterial thrombus at any location. As of today, this drug is readily used for this purpose in different clinical and interventional settings.
Urokinase is a physiologic thrombolytic agent that is produced in renal parenchymal cells. Unlike streptokinase, urokinase directly cleaves plasminogen to produce plasmin. When purified from human urine, approximately 1500 L of urine are needed to yield enough urokinase to treat a single patient. Urokinase is also commercially available in a form produced by tissue culture, and recombinant DNA techniques have been developed for urokinase production in E coli cultures.
In plasma, urokinase has a half-life of approximately 15 minutes. Allergic reactions are rare, and the agent can be administered repeatedly without antigenic problems.
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