The NICE recommendations are made on the proviso that the drug is used within the terms of its marketing authorisation. Treatment with alteplase should be initiated as early as possible after the onset of symptoms. Intracranial haemorrhage should be excluded using appropriate imaging techniques.
The update to the NICE guidance follows a revision to the licensed indications for alteplase which extends the time period within which the drug can be administered from three hours to 4.5 hours.
The appraisal committee concluded that alteplase administered between 0 and 4.5 hours after onset of stroke symptoms was an effective treatment for acute ischaemic stroke because it decreased the probability of death or dependence. It also considered the fact that extension of the treatment window may enable increased access to treatment with alteplase for patients in remote or rural locations.
NICE guidance on alteplase for stroke
View alteplase drug record