Neostreptaza (Streptodornase, Streptokinase)

Neostreptaza combines streptokinase and streptodornase to act on the fibrinolytic pathway and on purulent secretions. It is employed in the following clinical situations:

• Acute myocardial infarction: facilitates clot dissolution to restore coronary blood flow.
• Pulmonary embolism: promotes breakdown of embolic thrombi in the pulmonary arteries.
• Purulent respiratory secretions: hydrolyzes extracellular DNA, decreasing viscosity and aiding airway clearance.

• Streptokinase forms a complex with plasminogen, converting it to active plasmin that degrades fibrin clots, while streptodornase is a deoxyribonuclease that cleaves extracellular DNA, reducing the viscosity of purulent secretions. Together they provide both thrombolytic activity and mucolytic effect when administered rectally.

Adverse reactions may occur with Neostreptaza and should be monitored.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Rectal irritation: local discomfort at the site of administration.
• Mild bleeding: slight bruising or gum bleeding.
• Fever: low‑grade temperature elevation.
• Headache: transient cranial discomfort.
• Abdominal discomfort: mild cramping.

Serious or Rare Side Effects

• Severe hemorrhage: life‑threatening internal bleeding.
• Anaphylaxis: rapid allergic reaction with airway compromise.
• Hypotension: sudden drop in blood pressure.
• Disseminated intravascular coagulation: abnormal clotting throughout the body.
• Hemolysis: destruction of red blood cells.
• Severe abdominal pain: intense, persistent pain requiring medical attention.

Neostreptaza should be used with caution and under professional supervision.

• Assess bleeding risk: review patient history for coagulopathy, recent surgery, or trauma.
• Monitor coagulation parameters: check PT/INR and aPTT before and during therapy.
• Evaluate allergy history: avoid in patients with known hypersensitivity to streptokinase or bacterial enzymes.
• Use in pregnancy only if clearly needed: limited safety data are available.
• Store at room temperature: keep in the original container, protect from moisture and light.

Neostreptaza may interact with other medicines that affect haemostasis.

Major Interactions (Avoid)

• Concurrent anticoagulants (e.g., warfarin, heparin): markedly increased bleeding risk.
• Other fibrinolytics (e.g., alteplase, urokinase): additive thrombolytic effect leading to severe hemorrhage.
• Recent thrombolytic therapy: overlapping activity may cause uncontrolled bleeding.

Moderate Interactions (Monitor Closely)

• Antiplatelet agents (e.g., clopidogrel, aspirin): may enhance bleeding tendency.
• Non‑steroidal anti‑inflammatory drugs (NSAIDs): can potentiate gastrointestinal bleeding.
• ACE inhibitors: may contribute to hypotensive episodes when combined with streptokinase.