Adult Dosing
Acute MI
- <60 kg: 30 mg IV x 1
- 60-69 kg: 35 mg IV x 1
- 70-79 kg: 40 mg IV x 1
- 80-89 kg: 45 mg IV x 1
- >90 kg: 50 mg IV x 1
- Max: 50 mg
- Note: Initiate treatment as soon as possible after onset of myocardial infarction; safety and efficacy has only been demonstrated with concomitant heparin and aspirin
Pulmonary embolism [Non-FDA Approved]
- Weight based:
- <60 kg: 30 mg
- 60-69 kg: 35 mg
- 70-79 kg: 40 mg
- 80-89 kg: 45 mg
90 kg: 50 mg
- Note: All doses given IV push over 5 seconds
Acute Coronary Syndrome
- Weight based:
- <60 kg: 30 mg IV bolus
- 60-70 kg: 35 mg IV bolus
- 70-80 kg: 40 mg IV bolus
- 80-89 kg: 45 mg IV bolus
- 90 kg: 50 mg IV bolus
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
- Tenecteplase therapy can cause internal bleeding (intracranial, gastrointestinal, retroperitonial, genitourinary or respiratory) or superficial or surface bleeding. Monitor the patients and terminate the therapy immediately if any sign and symptom bleeding occurs
- Carefully evaluated and anticipated benefits weighed against potential risks associated with therapy before considering alteplase therapy in any patient
- Cholesterol embolism causing “purple toe” syndrome, acute renal failure, gangrenous digits, hypertension, pancreatitis, myocardial infarction, cerebral infarction, spinal cord infarction, retinal artery occlusion, bowel infarction, and rhabdomyolysis has been rarely reported in patients on thrombolytic drug
- When administering alteplase infusion, antiarrhythmic therapy for bradycardia and/or ventricular irritability should be readily available
- Implement standard management of myocardial infarction concomitantly with the therapy
Cautions: Use cautiously in
- Recent major surgery
- Recent trauma
- Recent GU bleeding
- Recent GP IIb/IIIa inhibitor use
- Anticoagulant use
- Cerebrovascular disorder
- Recent GI bleeding
- HTN
- Septic thrombophlebitis
- Occluded AV cannula
- Acute pericarditis
- SBE
- LV thrombus
- Hemostatic disorder
- Hemorrhagic retinopathy
Pregnancy Category:C
Breastfeeding: Safety unknown. Manufacturer advises caution when tenecteplase administered to a nursing woman.
