IV indicates intravenous; rPA, reteplase plasminogen activator; TIMI, Thrombolysis In Myocardial Infarction; TNK-tPA, tenecteplase tissue-type plasminogen activator; and tPA, tissue-type plasminogen activator. 5.1.3. Contraindications and Complications With Fibrinolytic Therapy Absolute and relative contraindications to fibrinolytic therapy are listed in Table 6. The decision to use fibrinolytic therapy for patients with STEMI is predicated on a risk benefit analy- sis that integrates time from onset of symptoms, the clinical and hemodynamic features at presentation, patient comorbidi- ties, risk of bleeding, presence of contraindications, and time delay to PCI (Section 3.2). 5.1.4. Adjunctive Antithrombotic Therapy With Fibrinolysis See Table 7 for a summary of recommendations from this section. 5.1.4.1. Adjunctive Antiplatelet Therapy With Fibrinolysis: Recommendations Class I 1. Aspirin (162- to 325-mg loading dose) and clopi- dogrel (300-mg loading dose for patients 75 years of age, 75-mg dose for patients >75 years of age) should be administered to patients with STEMI who receive fibrinolytic therapy.308,330,331 (Level of Evidence: A) 2. Aspirin should be continued indefinitely308,330,331 (Level of Evidence: A) and clopidogrel (75 mg daily) should be continued for at least 14 days330,331 (Level of Evidence: A) and up to 1 year (Level of Evidence: C) in patients with STEMI who receive fibrinolytic therapy. Class IIa 1. It is reasonable to use aspirin 81 mg per day in pref- erence to higher maintenance doses after fibrinolytic (Level of Evidence: B) The beneficial effects of aspirin and clopidogrel with fibrino- lytic therapy are well established.254,257,263,264 These agents should be given before or with the fibrinolytic.330 The recommendation that clopidogrel be continued for up to 1 year is extrapolated from the experience with DAPT in patients with non ST-elevation ACS.330 The coadministra- tion of other P2Y12 antagonists with fibrinolytic therapy has not been prospectively studied. 5.1.4.2. Adjunctive Anticoagulant Therapy With Fibrinolysis: Recommendations Class I 1. 