After WASHING hands using aseptic technique, reconstitute Cathflo to a final concentration of 2 mg/2 mL:
1. Aseptically WITHDRAW 2.2 mL of Sterile Water for Injection, USP (diluent is not provided). Do not use Bacteriostatic Water for Injection, USP.
2. INJECT the 2.2 mL of Sterile Water for Injection, USP, into the Cathflo vial, directing the diluent stream into the powder. Slight foaming is not unusual; let the vial stand undisturbed to allow large bubbles to dissipate.
3. Mix by gently SWIRLING until the contents are completely dissolved. Complete dissolution should occur within 3 minutes. DO NOT SHAKE. The reconstituted preparation results in a colorless to pale yellow transparent solution at a pH of approximately 7.3.
Single-use vial
Patient Weight | Cathflo Dose |
---|---|
≥30 kg (66 lb) | 2 mg in 2 mL |
<30 kg (66 lb) | 110% of the internal lumen of CVAD, not to exceed 2 mg in 2 mL |
If catheter function is not restored at 120 minutes after 1 dose of Cathflo, a second dose may be instilled (see Instructions for Administration). There is no efficacy or safety information on dosing in excess of 2 mg per dose for this indication. Studies have only evaluated up to two 2-mg doses.
No other medication should be added to solutions containing Cathflo.
Lyophilized Cathflo should be stored at refrigerated temperatures (2°C-8°C/36°F-46°F). Cathflo should be reconstituted immediately before use. The solution may be used within 8 hours if stored at 2°C to 30°C (36°F-86°F).
CVAD=central venous access device; INS=Infusion Nurses Society.
The INS Infusion Therapy Standards of Practice state that the instillation of alteplase 2 mg (Cathflo Activase) is safe and effective in restoring catheter patency in patients.2
Infusion Nurses Society. Infusion therapy standards of practice. J Infus Nurs. 2021:44(suppl 1):S1-S224.
Infusion Nurses Society. Infusion therapy standards of practice. J Infus Nurs. 2021:44(suppl 1):S1-S224.
Blaney M, Shen V, Kerner JA, et al; for CAPS Investigators. Alteplase for the treatment of central venous catheter occlusion in children: results of a prospective, open-label, single-arm study (the Cathflo Activase Pediatric Study). J Vasc Interv Radiol. 2006;17(11, pt 1):1745-1751.
Blaney M, Shen V, Kerner JA, et al; for CAPS Investigators. Alteplase for the treatment of central venous catheter occlusion in children: results of a prospective, open-label, single-arm study (the Cathflo Activase Pediatric Study). J Vasc Interv Radiol. 2006;17(11, pt 1):1745-1751.
Camp-Sorrell D, Matey L, ed. Access Device Standards of Practice for Oncology Nursing. 4th ed. Oncology Nursing Society; 2017.
Camp-Sorrell D, Matey L, ed. Access Device Standards of Practice for Oncology Nursing. 4th ed. Oncology Nursing Society; 2017.
McKnight S. Nurse's guide to understanding and treating thrombotic occlusion of central venous access devices. Medsurg Nurs. 2004;13(6):377-382.
McKnight S. Nurse's guide to understanding and treating thrombotic occlusion of central venous access devices. Medsurg Nurs. 2004;13(6):377-382.
Haire WD, Herbst SF. Consensus conference on the use of alteplase (t-PA) for the management of thrombotic catheter dysfunction. J Vasc Access Devices. 2000;5(2):28-36.
Haire WD, Herbst SF. Consensus conference on the use of alteplase (t-PA) for the management of thrombotic catheter dysfunction. J Vasc Access Devices. 2000;5(2):28-36.
AVA Resource Guide for Vascular Access, Association for Vascular Access, Second Edition, 2021, page 78.
AVA Resource Guide for Vascular Access, Association for Vascular Access, Second Edition, 2021, page 78.
Cummings-Winfield C, Mushani-Kanji T. Restoring patency to central venous access devices. Clin J Oncol Nurs. 2008;12(6):925-934.
Cummings-Winfield C, Mushani-Kanji T. Restoring patency to central venous access devices. Clin J Oncol Nurs. 2008;12(6):925-934.
Cathflo Prescribing Information. Genentech USA, Inc.
Cathflo Prescribing Information. Genentech USA, Inc.
Siegel JD, Rhinehart E, Jackson M, Chiarello L; Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. 2007:1-226.
Siegel JD, Rhinehart E, Jackson M, Chiarello L; Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. 2007:1-226.
Deitcher SR, Fesen MR, Kiproff PM, et al; for the Cardiovascular Thrombolytic to Open Occluded Lines-2 Investigators. Safety and efficacy of alteplase for restoring function in occluded central venous catheters: results of the Cardiovascular Thrombolytic to Open Occluded Lines trial. J Clin Oncol. 2002;20(1):317-324.
Deitcher SR, Fesen MR, Kiproff PM, et al; for the Cardiovascular Thrombolytic to Open Occluded Lines-2 Investigators. Safety and efficacy of alteplase for restoring function in occluded central venous catheters: results of the Cardiovascular Thrombolytic to Open Occluded Lines trial. J Clin Oncol. 2002;20(1):317-324.
Doellman D, Buckner JK, Garrett JH Jr, et al. Best practice guidelines in the care and maintenance of pediatric central venous catheters. 2015. http://www.ivas.online/newstyle/wp-content/uploads/2019/06/AVA-Pediatric-Guidelines-2nd-edition_web.pdf
Doellman D, Buckner JK, Garrett JH Jr, et al. Best practice guidelines in the care and maintenance of pediatric central venous catheters. 2015. http://www.ivas.online/newstyle/wp-content/uploads/2019/06/AVA-Pediatric-Guidelines-2nd-edition_web.pdf
Frey AM. Intravenous therapy in children. In: Hankins J, Lonsway RAW, Hedrick C, Perdue M, eds. Infusion Therapy in Clinical Practice. 2nd ed. WB Saunders; 2001:561-591.
Frey AM. Intravenous therapy in children. In: Hankins J, Lonsway RAW, Hedrick C, Perdue M, eds. Infusion Therapy in Clinical Practice. 2nd ed. WB Saunders; 2001:561-591.
Richardson D. Vascular access nursing: standards of care, and strategies in the prevention of infection: a primer on central venous catheters (part 2 of a 3-part series). JAVA. 2007;12(1):19-27.
Richardson D. Vascular access nursing: standards of care, and strategies in the prevention of infection: a primer on central venous catheters (part 2 of a 3-part series). JAVA. 2007;12(1):19-27.
Mohiaddin RH, Wann SL, Underwood R, Firmin DN, Rees S, Longmore DB. Vena caval flow: assessment with cine MR velocity mapping. Radiology. 1990;177(2):537-541.
Mohiaddin RH, Wann SL, Underwood R, Firmin DN, Rees S, Longmore DB. Vena caval flow: assessment with cine MR velocity mapping. Radiology. 1990;177(2):537-541.
Raaf JH. Results from use of 826 vascular access devices in cancer patients. Cancer. 1985;55(6):1312-1322.
Raaf JH. Results from use of 826 vascular access devices in cancer patients. Cancer. 1985;55(6):1312-1322.
Stephens LC, Haire WD, Kotulak GD. Are clinical signs accurate indicators of the cause of central venous catheter occlusion? J Parenter Enteral Nutr. 1995;19(1):75-79.
Stephens LC, Haire WD, Kotulak GD. Are clinical signs accurate indicators of the cause of central venous catheter occlusion? J Parenter Enteral Nutr. 1995;19(1):75-79.
National Institutes of Health. Management of central venous catheter occlusions. Pharm Update. 1999:1-4.
National Institutes of Health. Management of central venous catheter occlusions. Pharm Update. 1999:1-4.
Ryder M. The role of biofilm in vascular catheter-related infections. N Dev Vasc Dis. 2001;2:15-25.
Ryder M. The role of biofilm in vascular catheter-related infections. N Dev Vasc Dis. 2001;2:15-25.
Hadaway LC. Reopen the pipeline for IV therapy. Nursing. 2005;35(8):54-61.
Hadaway LC. Reopen the pipeline for IV therapy. Nursing. 2005;35(8):54-61.
Wingerter L. Vascular access device thrombosis. Clin J Oncol Nurs. 2003;7(3):345-348.
Wingerter L. Vascular access device thrombosis. Clin J Oncol Nurs. 2003;7(3):345-348.
Kaler W, Chinn R. Successful disinfection of needleless access ports: a matter of time and friction. JAVA. 2007;12(3):140-142.
Kaler W, Chinn R. Successful disinfection of needleless access ports: a matter of time and friction. JAVA. 2007;12(3):140-142.
Ponec D, Irwin D, Haire WD, et al. Recombinant tissue plasminogen activator (alteplase) for restoration of flow in occluded central venous access devices: a double-blind placebo-controlled trial—the cardiovascular thrombolytic to open occluded lines (COOL) efficacy trial. J Vasc Inter Radiol. 2001;12(8):951-955.
Ponec D, Irwin D, Haire WD, et al. Recombinant tissue plasminogen activator (alteplase) for restoration of flow in occluded central venous access devices: a double-blind placebo-controlled trial—the cardiovascular thrombolytic to open occluded lines (COOL) efficacy trial. J Vasc Inter Radiol. 2001;12(8):951-955.
Criddle LM. Ask the experts. Crit Care Nurse. 2007;27(3):78-81.
Criddle LM. Ask the experts. Crit Care Nurse. 2007;27(3):78-81.
The information contained in this section of the site is intended for U.S. healthcare professionals only. Click "OK" if you are a healthcare professional.
The link you have selected will take you away from this site to one that is not owned or controlled by Genentech, Inc. Genentech, Inc. makes no representation as to the accuracy of the information contained on sites we do not own or control. Genentech does not recommend and does not endorse the content on any third-party websites. Your use of third-party websites is at your own risk and subject to the terms and conditions of use for such sites.