How Long After TPA To Start Heparin (And Why)?

Exact Answer: 60 To 90 Minutes

TPA also known as Tissue plasminogen activator, and Heparin is mainly intravenous medicines that are used in different scenarios are per the requirement. Both of the medicines have the property to dissolve the blood clots that can form in the human body due to various reasons.

There are various medical conditions where these two medicines are used. Some of the major issues where TPA and Heparin are used are Ischemic stroke and pulmonary embolism. Ischemic stroke is where a blood clot forms in a human brain.

While pulmonary embolism is where there is a blockage in the pulmonary artery of the human lungs. Hence, TPA and Heparin are used during surgery or afterward to suppress blood clotting.


How Long After TPA To Start Heparin?

TPA or Tissue plasminogen activator is the most well-known and requested form of treatment for blood clot issues, whether it is Ischemic stroke or Pulmonary embolism. However, the use of Heparin is still not clear due to the medical consequences that might or might not help the case.

In some cases, it is advised to administer Heparin after a timeframe of 60 to 90 minutes post TPA for the full effect to show on the body. While in some cases, it is not advised to administer Heparin after TPA or alteplase is administered.

TPA is mostly used in thrombolytic therapy that is used on patients who have cases of acute pulmonary embolism. Since the purpose of the TPA is to avoid blood clotting, proper quantity must be administered in the body.

Heparin is an anticoagulant or otherwise knowns as a blood thinner. Heparin prevents blood clotting that happens either due to a medical condition or during a medical procedure. In some cases, Heparin can also be given to a patient before a medical procedure to prevent the risk of a blood clot.

Medicines are injected or administered with a definite cause behind them. The chemicals in the injection can cause different reactions in different humans. Hence sometimes, Heparin is not used post TPA.

BasisTime after which Heparin is to be administered post-TPA
Study 160 to 90 minutes after TPA
Study 2Not to be given along with TPA

Why Start Heparin After That Long After TPA?

Not all medicines will have the same result to all the patients that it is being administered to. The case is similar to that of the administration of TPA and Heparin together. 

There are a few reasons why in some cases Heparin can be given after a maximum of 90 minutes, while in some cases, Heparin is to be avoided altogether. A few of the reasons are as follows:

  • The primary reason for the timeframe is the medical procedure that is going to be administered to the patient. In case the patient is going under a medical procedure that has a high risk of blood clotting during the procedure or after the procedure, then Heparin can be included in the treatment to make the blood clot thinner.
  • However, there are cases where the patient does not have a high risk of getting blood clots during surgery or post-surgery. In such cases, it is better to use only one anticoagulant. 
  • In cases where the risk of blood clotting is low, including both TPA and Heparin can cause more harm than good. It can go on to make the blood very thin, which can cause a lot of blood loss. 
  • Post-surgery, extremely thin blood can lead to other medical conditions too. Hence, administration of TPA and Heparin together is case to case to basis only.


Although some cases may allow the use of both TPA and Heparin one after the other, it is imminent to make sure what quantity is being used when both the medicines are used together.

It is also necessary that there is a time gap between the medicine administration of TPA and Heparin to avoid further medical problems.

TPA is to be administered with three hours of Ischemic stroke or pulmonary embolism, to be effective. On the other hand, Heparin can be given before surgery too. However, if both the medicines are to be used together, a minimum time gap of 60 minutes is to be maintained mandatorily.


Avatar of Nidhi


Hi! I'm Nidhi.

Here at the EHL, it's all about delicious, easy recipes for casual entertaining. So come and join me at the beach, relax and enjoy the food.

Leave a Reply

Your email address will not be published. Required fields are marked *