tissue plasminogen activator + dornase alfa

This is a combination therapy of tissue plasminogen activator (tPA), most commonly in the recombinant form as alteplase, and dornase alfa (recombinant human deoxyribonuclease I). The combination is administered intrapleurally for the treatment of pleural infections such as empyema that are not resolving with standard management. - **Mechanism of Action:** - Tissue plasminogen activator (tPA/alteplase) is a serine protease that catalyzes the conversion of plasminogen to plasmin, leading to fibrin degradation and breakdown of fibrinous septations within infected pleural fluid collections[6][8]. - Dornase alfa enzymatically cleaves extracellular DNA present in pus and thick pleural fluid, reducing viscosity and facilitating drainage[2][3][5]. - **Clinical Use:** This combination has been shown in randomized trials to improve drainage, reduce surgical referral rates, and shorten hospital stays compared to either agent alone or placebo for patients with complicated parapneumonic effusions or empyema[2][5][7]. It is used when standard chest tube drainage plus antibiotics are insufficient.

Brand names

Pulmozyme

Other names

tPA + DNasealteplase + dornase alfa