Tenecteplase

Administration

  • Type: Thrombolytic
  • Dosage Forms:
  • Routes of Administration: IV
  • Common Trade Names:

Adult Dosing

Thrombolysis for PE

Acute myocardial infarction

  • <60kg: 30mg IV bolus over 5s
  • 60-69kg: 35 mg IV bolus over 5s
  • 70-79 kg: 40 mg IV bolus over 5s
  • 80-89kg: 45 mg IV bolus over 5s
  • >90 kg: 50 mg IV bolus over 5s

Pediatric Dosing

Safety/efficacy not established

Special Populations

Pregnancy Rating

  • Pregnancy category C (fetal risk cannot be ruled out)

Lactation risk

  • Infant risk cannot be ruled out

Renal Dosing

  • Adult: not established

Hepatic Dosing

  • Adult: not established

Contraindications

  • Allergy to class/drug
  • Active internal bleeding
  • Known bleeding diathesis
  • Recent (<2m) intracranial or intraspinal surgery or trauma
  • Intracranial neoplasm, AVM, or aneurysm
  • History of CVA
  • Severe, uncontrollable hypertension


Adverse Reactions

Serious

  • Upon coronary reperfusion: Dysrhythmia, cholesterol embolus (rare)
  • Major hemorrhage, GI bleed, intracranial hemorrhage, renal artery hemorrhage
  • CVA
  • Thromboembolism
  • Anaphylaxis, hypersensitivity reaction

Common

  • Minor hemorrhage: hematoma, GI bleed, renal artery hemorrhage

Pharmacology

  • Half-life: 90-130m
  • Metabolism: Hepatic
  • Excretion:

Mechanism of Action

  • Binds fibrin, converts plasminogen to plasmin

Comments


See Also

  • Thrombolysis
  • Thrombolysis for PE
  • Thrombolytics in STEMI

References

  1. Fatovich D, Dobb G, Clugston R. A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial). Resuscitation. 2004;61(3):309-313.
  2. Bozeman W, Kleiner D, Ferguson K. Empiric tenecteplase is associated with increased return of spontaneous circulation and short term survival in cardiac arrest patients unresponsive to standard interventions. Resuscitation. 2006;69(3):399-406.
  3. Böttiger B, Arntz H, Chamberlain D, et al. Thrombolysis during resuscitation for out-of-hospital cardiac arrest. N Engl J Med. 2008;359(25):2651-2662.
  • Micromedex
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