Thrombolytic therapy should be avoided within the first 18 weeks of pregnancy because of the risk of placental separation. There is no information regarding the use of streptokinase in lactating women. It is not known whether streptokinase is excreted in breast milk nor whether it has harmful effects on the newborn. It is recommended that breast-feeding be discontinued in a woman who is to receive streptokinase. Streptokinase alone or in combination with antiplatelet agents and anticoagulants may cause bleeding complications.
Careful monitoring is essential.
In the treatment of acute myocardial infarction, low dose ASA when not otherwise contraindicated can be administered with streptokinase. Optimal treatment in acute myocardial infarction with anticoagulants after thrombolysis is not yet established. However, anticoagulant therapy for other indications should follow treatment with streptokinase to prevent rethrombosis. Heparin therapy should not be started earlier than 4 hours after administration of streptokinase. If such bleeding occurs, local measures should be taken to control the bleeding.