CATL-3480_M2_Dosing_Card_FOF.indd11-6-2018 12:52 PM Judy Law / Arthur George

Client CodeClient

LiveOverall TrimBleed

# of Colors

CAT/082815/0056(3)Genentech/Cathflo

3" x 7"3.5" x 7.5"3.75" x 7.75"

4/4 Process

Colors Cyan, Magenta, Yellow, Black

FontsITC Avant Garde Gothic Std (Bold, Demi, Book)

Job info Fonts & ColorsImages

Saved at

None

from hsesfl7823 by

Printed At

3480_Main_Grad_with_Cat_HR.tif (CMYK; 300 ppi; 100%), 3480_Bottom_Grad_HR.tif (CMYK; 1381 ppi, 425 ppi; 21.72%, 70.49%), 2016_Vial_HR.tif (CMYK; 3401 ppi; 8.82%), 69454_purple button.ai (38.41%), 3-Reconstitution_Swirl_HR.psd (CMYK; 5955 ppi; 5.04%), 7-Administration_Instill_HR.psd (CMYK; 4973 ppi; 6.03%), 10-Administration_Aspirate_HR.psd (CMYK; 7260 ppi; 4.13%), 1-Reconstitution_Withdraw_HR.psd (CMYK; 5923 ppi; 5.06%), 2-Reconstitution_Inject_HR.psd (CMYK; 6794 ppi; 4.42%), 8-Admin-istration_Dwell_HR.psd (CMYK; 11285 ppi; 2.66%), 70621_clocks-2.ai (49.3%, 48.86%), 9-Administration_Assess_HR.psd (CMYK; 6460 ppi; 4.64%), Gene_Logo_4C_T.ai (30.91%), Cathflo_Logo_4C_noTag.ai (10%), 3480_Dosing_Small.ai (59.9%)

Notes Cathflo Dosing Card

30minutes

120minutes

30minutes

120minutes

www.cathflo.com

<30 kg (66 lb) 110% of the internal lumen volume of CVAD, not to exceed 2 mg in 2 mL

Patient weight Cath�o dose

30 kg (66 lb) 2 mg in 2 mL

Cathflo® Activase® (alteplase) Dosing and AdministrationCathflo 2 mg is the standard of care for treatment of thrombotically occluded catheters

Administration1

After WASHING hands and applying gloves:

Note: Store lyophilized Cathflo at refrigerated temperature (2̊ C–8̊ C/36̊ F–46̊ F). Cathflo should be reconstituted immediately before use. The solution may be used within 8 hours if stored at 2̊ C to 30̊ C (36̊ F–86̊ F). No other medication should be added to solutions containing Cathflo.

If catheter function has been restored, ASPIRATE 4 mL to 5 mL of blood in patients ≥10 kg or 3 mL in patients <10 kg to remove Cathflo and residual clot. Then discard aspirate, and flush catheter with 0.9% Sodium Chloride, USP.Any unused solution should be discarded.

INSTILL the appropriate dose of Cathflo into the occluded catheter using a 10-mL syringe (see dosing chart below).

ASSESS catheter function after a total of 120 minutes of dwell time by attempting to aspirate blood. If catheter is functional, go to step 5. If catheter is still occluded, a second dose of equal amount may be instilled. Repeat steps 1 through 3.

After 30 minutes of DWELL time, assess catheter function by attempting to aspirate blood. If the catheter is functional, go to step 5; if not functional, go to step 4.

After performing hand hygiene and donning gloves, aseptically reconstitute using 2.2 mL sterile water for injection and INSPECT solution for foreign matter and discoloration.

1

2

3

5

4

Single-use vial

Administration1

FDA-approved dosing with Cathflo Activase (alteplase) 2 mg1(alteplase) 2 mg1FDA-approved dosing with Cathflo Activase

IndicationCathflo Activase (alteplase) is indicated for the restoration of function to central venous access devices as assessed by the ability to withdraw blood.Important Safety InformationContraindicationsCathflo Activase should not be administered to patients with known hypersensitivity to alteplase or any component of the formulation.

Important Safety Information

Indication

Please see additional Important Safety Information on reverse side.

CVAD=central venous access device.

S:3”S:7”

T:3.5”T:7.5”

B:3.75”B:7.75”

CATL-3480_M2_Dosing_Card_FOF.indd11-6-2018 12:52 PM Judy Law / Arthur George

Client CodeClient

LiveOverall TrimBleed

# of Colors

CAT/082815/0056(3)Genentech/Cathflo

3" x 7"3.5" x 7.5"3.75" x 7.75"

4/4 Process

Colors Cyan, Magenta, Yellow, Black,

FPO-DoNotPrint

FontsITC Avant Garde Gothic Std (Bold, Demi, Book, Bold Oblique, Bold Condensed, Book Condensed, Book Condensed Oblique)

Job info Fonts & ColorsImages

Saved at

None

from hsesfl7823 by

Printed At

3480_Main_Grad_with_Cat_HR.tif (CMYK; 300 ppi; 100%), 3480_Bottom_Grad_HR.tif (CMYK; 1381 ppi, 425 ppi; 21.72%, 70.49%), Gene_Logo_4C_T.ai (30.91%), Barcode_FPO_20percent_Red.pdf (100%), FSC_LNBW_Logo_K.eps (40.95%), Cathflo_Logo_4C_noTag.ai (10%)

Notes Cathflo Dosing Card

www.cathflo.com

Cathflo® Activase® (alteplase) Dosing and AdministrationCathflo 2 mg is the standard of care for treatment of thrombotically occluded catheters

Please see Indication and Important Safety Information on reverse side. Please see accompanying full Prescribing Information for additional important safety information.

Highest Level of Evidence in CVAD GuidelinesCVAD GuidelinesHighest Level of Evidence in

PrecautionsGeneralCertain causes of catheter dysfunction should be considered before treatment with Cathflo Activase (e.g. catheter malposition, mechanical failure, constriction by a suture and lipid deposits or drug precipitates within the catheter lumen). These types of conditions should be considered before treatment with Cathflo Activase.BleedingThe most frequent adverse reaction associated with all thrombolytics in all approved indications is bleeding.Should serious bleeding in a critical location (e.g., intracranial, gastrointestinal, retroperitoneal, pericardial) occur, treatment with Cathflo Activase should be stopped and the drug should be withdrawn from the catheter.InfectionsCathflo Activase should be used with caution in the presence of known or suspected infection in the catheter.HypersensitivityHypersensitivity, including urticaria, angioedema and anaphylaxis, has been reported in association with use of Cathflo Activase. Monitor patients treated with Cathflo Activase for signs of hypersensitivity and treat appropriately if necessary.Adverse ReactionsIn clinical trials, the most serious adverse events reported after treatment were sepsis, gastrointestinal bleeding, and venous thrombosis.

Cathflo is the only thrombolytic recommended by clinical practice standards, including the Infusion Nurses Society (INS), Association for Vascular Access (AVA), American Association of Critical Care Nurses (AACN), and Oncology Nursing Society (ONS).2-7

Use 2 mg alteplase (Cathflo Activase) to restore patency and maintain catheter function.3

— Class 1; Level of Evidence A, ONS Access Device Standards of Practice, 2017, page 10, section VI, practice standard B

References: 1. Cathflo Prescribing Information. Genentech USA, Inc. 2. Infusion Nurses Society. Infusion therapy standards of practice. J Infus Nurs. 2016;39 (suppl 1):S1-S159. 3. Camp-Sorrell D, ed. Access Device Standards of Practice for Oncology Nursing. 4th ed. Pittsburgh, PA: Oncology Nursing Society; 2017. 4. McKnight S. Nurse’s guide to understanding and treating thrombotic occlusion of central venous access devices. Medsurg Nurs. 2004;13(6):377-382. 5. Haire WD, Herbst SF. Consensus conference on the use of alteplase (t-PA) for the management of thrombotic catheter dysfunction. J Vasc Access Devices. Summer 2000:1-8. 6. Criddle LM. Ask the experts. Crit Care Nurse. 2007;27(3):78-81. 7. Cummings-Winfield C, Mushani-Kanji T. Restoring patency to central venous access devices. Clin J Oncol Nurs. 2008;12(6):925-934.

© 2018 Genentech USA, Inc. All rights reserved. CAT/082815/0056(3) Printed in USA.

Instillation of alteplase 2 mg (Cathflo Activase) based on manufacturers’ directions for use is recommended in current guidelines. There is limited research available to support the efficacy of thrombolytic drugs for alternative dosing.2

— Class 1; Level of Evidence A, INS Infusion Therapy Standards of Practice, 2016, page S105, standard 48, practice criterion G -2

Important Safety InformationImportant Safety Information (cont’d)Important Safety Information (cont'd)

S:3”S:7”

T:3.5”T:7.5”

B:3.75”B:7.75”