Demystify Intrapleural Alteplase and Dornase Alfa Therapy

August 2025

Pharmacists are asking for tips about administering alteplase (Activase) and dornase alfa (Pulmozyme) off-label through chest tubes.

We know IV alteplase breaks down blood clots...and inhaled dornase alfa helps clear mucus in cystic fibrosis.

But these meds can also be dwelled intrapleurally (IP)...into the space between the lung and chest wall via chest tubes...to help clear pockets of pus (empyema, etc), blood (hemothorax), or pleural fluid.

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