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Title: BP Control in Stroke Patients Receiving Thrombolytics

Category: Neurology

Keywords: blood pressure control, stroke, tPA, thrombolytics (PubMed Search)

Posted: 3/19/2009 by Aisha Liferidge, MD (Updated: 7/21/2026)

  • A patient's blood pressure should be maintained at less than 185/110 prior to receiving thrombolytics for stroke.
  • The following medications should be used to address blood pressure control in these patients:

               Labetalol 10 to 20 mg IV over 1 to 2 minutes, may repeat x 1  

               OR

               Nitropaste 1 to 2 inches

               OR

               Nicardipine infusion at 5 mg per hour, titrate by 0.25 mg/hr at 5 to 10 minute intervals up to a maximum

               dose of of 15 mg/hr.  Once desired blood pressure is achieved, titrate down in increments of 3 mg/hr. 

          


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