Drug Interaction Report

Aspirin Rectal and Alteplase, Recombinant: Interaction Details

A pharmacist-reviewed analysis of the Aspirin Rectal and Alteplase, Recombinant interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Jul 11, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Aspirin Rectal

Aspirin
+

Alteplase, Recombinant

Activase
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Jul 11, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 385 documented Aspirin Rectal interactions, 268 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

An increased risk of bleeding

Interaction Deep Dive

Use caution with the coadministration of alteplase and an antiplatelet agent due to an increased risk bleeding. Bleeding may occur when an antiplatelet agent is administered before, during, and after alteplase therapy. If concomitant use is required, close monitoring for bleeding is recommended, especially at arterial puncture sites1.

Why it happens (mechanism)

Additive effects

Common questions

Can I take Aspirin Rectal and Alteplase, Recombinant together?

An increased risk of bleeding Always confirm with your pharmacist or prescriber before making any change.

How serious is the Aspirin Rectal and Alteplase, Recombinant interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Aspirin Rectal or Alteplase, Recombinant need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (1)

  1. Product Information: ACTIVASE(R) IV injection, alteplase IV injection. Genentech,Inc, South San Fransisco, CA, 2005.
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Aspirin Rectal

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