Last reviewed 2026-04-23 · How we verify

Low-dose rtPA

Low-dose rtPA is a thrombolytic agent that activates plasminogen to dissolve blood clots by converting it to plasmin.

Low-dose rtPA is a thrombolytic agent that activates plasminogen to dissolve blood clots by converting it to plasmin. Used for Acute ischemic stroke, Acute pulmonary embolism.

At a glance

Mechanism of action

rtPA (recombinant tissue plasminogen activator) is a serine protease that binds to fibrin in blood clots and catalyzes the conversion of plasminogen to plasmin, which degrades fibrin and dissolves the clot. At lower doses than standard thrombolytic regimens, it aims to achieve thrombolysis while potentially reducing bleeding complications. The George Institute is investigating low-dose rtPA formulations for acute stroke and other thromboembolic conditions.

Approved indications

• Acute ischemic stroke
• Acute pulmonary embolism

Common side effects

• Intracranial hemorrhage
• Systemic bleeding
• Reperfusion injury

Key clinical trials

• Low Dose Thrombolysis, Ultrasound Assisted Thrombolysis or Heparin for Intermediate High Risk Pulmonary Embolism (PHASE3)
• Catheter-Directed Thrombolysis Versus Anticoagulation Monotherapy in Intermediate-High Risk PE (PHASE3)
• Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED) (PHASE3)
• A Trial in Recombinant Human Prourokinase to Treat Acute Pulmonary Embolism (PHASE2)
• Tenecteplase Reperfusion Therapy in Acute Ischemic Cerebrovascular Events(TRACE) (PHASE2)
• Safety and Efficacy of Two Doses of SP-8203 in Patients With Ischemic Stroke Requiring rtPA (PHASE2)
• Injection of Recombinant Human Tissue-type Plasminogen Activator Derivative for Acute Pulmonary Embolism(rPA) (PHASE2)
• Low-dose Versus Standard Dose Alteplase in Acute Ischemic Stroke , 4 Monthes Prospective Study (PHASE4)

Primary sources

Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.