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Updated: Jun 29, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Decrease in blood pressure after intravenous administration of urapidil during recombinant tissue plasminogen
Jean-Marc Bugnicourt1, Cécile Duru, Candice Picard
1Department of Neurology and Laboratoire de Neurosciences Fonctionnelles et Pathologies (UMR CNRS 8160), Amiens University Hospital, Amiens, France. bugnicourt.jean-marc@chu-amiens.fr
Clinical Therapeutics
|October 9, 2008
Summary
Intravenous urapidil may cause hypotension during acute ischemic stroke thrombolysis. This case highlights potential risks in elderly patients treated with diuretics, emphasizing careful blood pressure management.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Acute ischemic stroke treatment often requires blood pressure management.
- Recombinant tissue plasminogen activator (rtPA) is a key thrombolytic therapy.
- Uncertainty exists regarding optimal antihypertensive agents during rtPA therapy.
Observation:
- A patient receiving rtPA for ischemic stroke experienced a rapid BP increase.
- Intravenous urapidil was administered to lower blood pressure.
- The patient developed neurologic worsening and hypotension post-urapidil administration.
Findings:
- Hypotension occurred shortly after IV urapidil bolus during rtPA thrombolysis.
- The patient's condition improved after rtPA discontinuation and fluid resuscitation.
- Full recovery was achieved by 6-month follow-up.
Implications:
- Caution is advised when using IV urapidil in elderly stroke patients on diuretics.
- Careful hemodynamic monitoring is crucial during rtPA thrombolysis.
- This case suggests a potential adverse interaction between urapidil and rtPA in specific patient populations.
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