TABLE 4.

Antiplatelet, Anticoagulant, and Thrombolytic Medications

MedicationRouteDosage
AspirinOralAntiplatelet dose: 3–5 mg/kg every day
ClopidogrelOral1 mg/kg per day* to max (adult dose) of 75 mg/day
DipyridamoleOral 2–6 mg/kg per day in 3 divided doses
Unfractionated heparinIntravenousLoad: 50 U/kg
Infusion: 20 U/kg/h
Adjust dosage to achieve desired therapeutic level, usually plasma heparin level=0.35–0.7 in antifactor Xa activity or aPTT 60–85 s
Low-molecular-weight heparinSubcutaneousInfants <12 months
    Treatment: 3 mg/kg per day, divided every 12 h
    Prophylaxis: 1.5 mg/kg per day, divided every 12 h
Children/adolescents
Treatment: 2 mg/kg per day, divided every 12 h
    Prophylaxis: 1.5 mg/kg per day, divided every 12 h
    Prophylaxis: 1 mg/kg per day, divided every 12 h
    Prophylaxis: 1.5 mg/kg per day, divided every 12 h
Adjust dose to achieve desired therapeutic level, usually antifactor Xa = 0.5–1.0 U/mL
AbciximabIntravenousBolus: 0.25 mg/kg
Infusion: 0.125 μg/kg per min for 12 h
StreptokinaseIntravenousBolus: 1000–4000 U/kg over 30 min
Infusion: 1000–1500 U/kg per h
tPAIntravenousBolus: 1.25 mg/kg
Infusion: 0.1–0.5 mg/kg per h for 6 h, then reassess
UrokinaseIntravenousBolus: 4400 U/kg over 10 min
Infusion: 4400 U/kg per h
WarfarinOral0.1 mg/kg per day, given every day (0.05–0.34 mg/kg per day; adjust dose to achieve desired INR, usually 2.0–2.5)
  • No published studies in children.

  • Clopidogrel is preferred to dipyridamole, based on adult studies.