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tenecteplase

B01AD11

Forms & Strengths

Lyophilized powder for injection: 50 mg (10,000 units) single-use vial

Adult Dosing

Acute Myocardial Infarction: Single weight-based intravenous bolus over 5 seconds
<60 kg: 30 mg (6 mL)
60 to <70 kg: 35 mg (7 mL)
70 to <80 kg: 40 mg (8 mL)
80 to <90 kg: 45 mg (9 mL)
≥90 kg: 50 mg (10 mL)
Acute Ischemic Stroke: 0.25 mg/kg single intravenous bolus (maximum dose 25 mg) administered over 5 seconds

Pediatric Dosing

Safety and efficacy not established in pediatric patients

Indications

Management of acute myocardial infarction (STEMI) to reduce mortality
Management of acute ischemic stroke within 4.5 hours of symptom onset

Mechanism of Action

Recombinant tissue-type plasminogen activator (tPA) produced by recombinant DNA technology
Binds to fibrin in a thrombus and converts entrapped plasminogen to plasmin
Initiates local fibrinolysis, leading to clot dissolution
Exhibits higher fibrin specificity and greater resistance to inactivation by plasminogen activator inhibitor-1 (PAI-1) compared to alteplase

Contraindications

Active internal bleeding
History of cerebrovascular accident (stroke), intracranial hemorrhage, or major surgery/head trauma within recent months
Intracranial neoplasm, arteriovenous malformation, or aneurysm
Severe uncontrolled hypertension
Known bleeding diathesis

Adverse Reactions

Major and minor bleeding events (hemorrhage)
Intracranial hemorrhage
Allergic reactions, including anaphylaxis, rash, and urticaria
Cholesterol embolism

Drug Interactions

Anticoagulants (e.g., heparin, warfarin, direct oral anticoagulants): increased risk of severe bleeding
Antiplatelet agents (e.g., aspirin, P2Y12 inhibitors, GPIIb/IIIa inhibitors): increased risk of hemorrhage

Curated Content: Needs Vetting Before Put to Clinical Use