Tenecteplase

DEA Class; Rx

Common Brand Names; TNK tPA, TNKase

  • Thrombolytics

Recombinant thrombolytic agent given as single IV bolus for AMI
Longer half-life, increased fibrin specificity, and increased resistance to PAI-1 compared to alteplase with similar clinical outcomes of 30-day mortality, intracranial bleeding, and minor bleeding
Major (non-cerebral) bleeding and blood transfusions were lower with tenecteplase (ASSENT 2 trial) compared to alteplase

Indicated for the treatment of acute myocardial infarction with ST-elevation (STEMI) due to coronary artery thrombosis.

For re-establishing patency of an occluded IV catheter or occluded arteriovenous (AV) cannula.
For the treatment of acute ischemic stroke.

Hypersensitivity

Active bleeding, history of CVA, recent (within 2 months) intracranial or intraspinal surgery or trauma, intracranial neoplasm, AVM, aneurysm, bleeding diathesis, severe uncontrolled HTN, recent (within 3 mth) facial trauma, suspected aortic dissection

Minor bleeding (22%)

Reperfusion arrhythmias

MI

Fever

Nausea

Vomiting

Cholesterol embolization

Allergic reaction

Hypersensitivity, including urticarial/anaphylactic reactions, reported after administration of TNKase (eg, anaphylaxis, angioedema, laryngeal edema, rash, and urticaria); monitor patients treated with TNKase during and for several hours after infusion; if symptoms of hypersensitivity occur, initiate appropriate therapy

Standard management of myocardial infarction should be implemented concomitantly with TNKase treatment; arterial and venous punctures should be minimized; noncompressible arterial puncture must be avoided and internal jugular and subclavian venous punctures should be avoided to minimize bleeding from the non-compressible sites

The use of thrombolytics can increase the risk of thrombo-embolic events in patients with high likelihood of left heart thrombus, such as patients with mitral stenosis or atrial fibrillation

Readministration of plasminogen activators, including TNKase, to patients who have received prior plasminogen activator therapy has not been systematically studied; although sustained antibody formation in patients receiving one dose of TNKase has not been documented,readministration should be undertaken with caution

There are no adequate and well-controlled studies in pregnant women; therapy should be given to pregnant women only if potential benefits justify potential risk to fetus

Not known if this drug is excreted in human milk; because many drugs are excreted in human milk, exercise caution when this drug is administered to a nursing woman

Adults

50 mg/total dose IV.

Geriatric

50 mg/total dose IV.

Adolescents

Safety and efficacy have not been established.

Children

Safety and efficacy have not been established.

Infants

Safety and efficacy have not been established.

Tenecteplase

powder for injection

  • 50mg

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